管德佳

[摘要]目的 探讨球囊扩张术治疗输尿管结石并狭窄的临床效果。方法 选取2015年3月～2018年3月我院泌尿外科收治的100例输尿管狭窄患者作为研究对象，随机分为两组。对照组患者采取常规管腔扩张手术，观察组患者采取球囊扩张微创手术，比较两组患者的治愈率、手术时间、术中失血量、术后胃肠恢复时间、治疗时间。结果 观察组患者的治愈率（84.00%）与对照组（82.00%）比较，差异无统计学意义（P>0.05）；观察组患者的手术时间、胃肠恢复时间、治疗时间均明显短于对照组，术中出血量少于对照组，差异有统计学意义（P<0.05）；观察组患者的不良反应发生率明显低于对照组，差异有统计学意义（P<0.05）。结论 常规腔内扩张手术治疗与球囊扩张微创手术治疗输尿管狭窄的效果相似，但球囊扩张微创手术操作更简单，可缩短手术时间，且术中出血少，术后胃肠功能恢复快，可缩短患者的住院时间，值得推广。

[关键词]球囊扩张术；输尿管狭窄；输尿管结石；手术治疗；微创治疗

[中图分类号] R699 [文献标识码] A [文章编号] 1674-4721（2018）5（a）-0076-03

[Abstract]Objective To investigate the clinical effect of balloon dilation in the treatment of ureteral calculi and stenosis.Methods One hundred patients with ureteral calculi and stenosis treated in our hospital from March 2015 to March 2018 were selected as the study subjects，and divided into two groups radomly.Patients in the control group were treated with conventional intracavitary dilation surgery.Patients in the observation group were treated with balloon dilation and minimally invasive surgery.The cure rate，operation time，intraoperative blood loss，postoperative gastrointestinal recovery time，treatment time were compared between the two groups.Results There was no significant difference in the cure rate between the observation group （84.00%） and the control group （82.00%） （P>0.05）.The operation time，gastrointestinal recovery time，treatment time in the observation group were significantly shorter than those in the control group，intraoperative blood loss was less than the control group，the differences were statistically significant （P<0.05）.The incidence of adverse reactions in the observation group was significantly lower than that in the control group，the difference was statistically significant （P<0.05）.Conclusion The effect of conventional intracavitary dilation surgery and balloon dilatation minimally invasive surgery is similar to that of ureteral stricture.However，the operation of balloon dilatation and minimally invasive surgery is simpler，which can shorten the operation time，less bleeding during operation，rapid recovery of postoperative gastrointestinal function，and can shorten the hospital stay，which is worth promoting.

[Key words]Balloon dilation；Ureteral calculi；Ureteral stricture；Surgical treatment；Minimally invasive treatment

輸尿管狭窄是泌尿外科临床的常见疾病，其发病因素较多，如先天性因素和炎症、结石、医源性因素等，发病后患者患侧可出现肾积水，引发肾功能损害和丧失。目前治疗输尿管结石的临床方法主要有两种，包括手术治疗和保守治疗。既往多采用常规管腔扩张手术治疗[1-2]。但因其手术操作时间长、效果差、并发症多等缺点，患者往往不易接受传统手术治疗。随着泌尿外科医疗器械及治疗技术的迅速发展，输尿管镜下碎石术已广泛应用于临床，而腔内碎石设备种类较多，球囊扩张术治疗输尿管结石并狭窄近年来被用于临床，本研究旨在探讨球囊扩张术治疗输尿管结石并狭窄的临床效果，现报道如下。

1资料与方法

1.1 一般资料

选取2015年3月～2018年3月我院泌尿外科收治的100例输尿管狭窄患者作为研究对象，术前均行尿路造影、泌尿系B超、CT三维扫描、肾穿刺造影检查等，明确输尿管的狭窄部位、程度和长度、患侧情况。所……