目的 探讨输尿管镜联合扩张法治疗短段输尿管良性狭窄的临床疗效及安全性。方法 回顾性分析 2012年 1月至 2015年 12月红河州第二人民医院收治的 110例良性输尿管狭窄并接受输尿管镜手术扩张的患者的临床资料。根据手术方式分为研究组（输尿管镜联合扩张组）和对照组（输尿管镜直接扩张组）。研究组 62例，男 41例，女 21例，年龄 41（27）岁，体质量指数（ BMI）25（4）kg/m2，输尿管狭窄长度 0.9（0.3）cm，于输尿管镜下联合应用斑马导丝、输尿管导管及异物钳等常用器材扩张输尿管狭窄段。对照组 48例，男 31例，女 17例，年龄 43（28）岁， BMI 25（6）kg/m2，输尿管狭窄长度 0.8（0.4）cm，单纯采取斑马导丝或导管引导输尿管镜镜体硬性扩张狭窄段。比较两组狭窄扩张时间、扩张成功率、并发症发生率、远期治愈率的差异。结果 研究组与对照组相比，狭窄扩张时间缩短[6（5） vs 20（16） min, P<0.05）]，扩张成功率提高（ 98.4% vs 87.5%，P<0.05），并发症发生率下降（ 4.8% vs 14.6%, P<0.05），远期治愈率提高（ 96.4% vs 84.4 %, P<0.05）。结论 输尿管镜联合扩张法应用常规器材扩张短段的输尿管良性狭窄，安全性高，疗效确切，器材简单实惠，适合在基层医院中探索应用。
Objective To evaluate the clinical efficacy and safety of combined ureteroscopic dilatation for the treatment of short-segment benign ureteric strictures. Methods The clinical data of 110 cases with benign ureteric strictures which received ureteroscopic dilatation treatment in the Second Hospital of Honghezhou from January 2012 to December 2015 were analyzed retrospectively. According to surgical approach the patients were divided into study group (ureteroscopic combined dilation method group) and control group (ureteroscopic direct dilatation method group). The study group included 62 patients(41 males and 21 females), 41(27) years old, BMI was 25(4) kg/m2, length of ureteric strictures was 0.9(0.3) cm. In this method, under direct ureteroscopic view common conventional equipment like zebra guide wires, ureteral catheters and foreign body clamps were used together for dilation of ureteric strictures. The control group included 62 patients (31 males and 17 females), 43(28) years old, BMI was 25.4(6) kg/m2, length of ureteric strictures was 0.8 (0.4) cm. In this method, the zebra guide wires or urethral catheters were passed through the ureteric strictures and then the stricture was rigidly dilated using the ureteroscope. The parameters between the two groups, such as time taken for the dilatation of the urethral strictures, the success rate of expansion, the incidence of complications, and the long-term curative rate were compared . Results Compared with the control group, the time taken for the dilatation of the urethric strictures was reduced in study group [6(5) vs 20(16) min, P<0.05], success rate of the dilatation was higher (98.4% vs 87.5%, P<0.05), incidence of complications decreased (4.8% vs 14.6%，P<0.05), long-term curative rate increased (96.4% vs 84.4%, P<0.05). Conclusion s Combined ureteroscopic dilatation with conventional instruments for the treatment of short-segment ureteric strictures is safe and effective. The procedures are simple and affordable. The application of this method is suitable in primary level hospitals.
