输尿管

Methods 25 patients with upper tract transitional cell carcinoma underwent resection under Laparoscope and cystoscope. Integrity and the detent of ureterostoma was detected after the operation.

对25例肾盂肿瘤或中上段输尿管肿瘤的患者采取腹腔镜联合膀胱镜行肾、输尿管全长切除，术后检查手术标本的完整性，并行输尿管内压力测定，对输尿管口的封闭性进行评估。

From April 2000 to June 2002, 512 cases of laparoscopical urologic operation have been performed through transperitoneal and retroperitoneal or extraperitoneal approach: 41 cases of nephrectomy, 36 cases of radical nephrectomy, 10 cases of nephroureterectomy with cystoscopic en bloc excision of the distal ureter and bladder cuff, 3 cases of partial nephrectomy, 78 cases of partial adrenalectomy or resection of adenomas, 71 cases of total adrenalectomy, 17 cases of ureterolithotomy, 122 cases of decortication of renal cyst, 1 case of Anderson-Hynes dismembered pyeloplasty, 7 cases of renal pedical lymphatics disconnection, 2 cases of relative living donor nephrectomy.

本课题通过对223例肾疾病、149例肾上腺疾病、17例输尿管结石病人进行腹腔镜及后腹腔镜手术，其中肾囊肿去顶术140例、单纯肾切除术41例、根治性肾切除术36例、肾输尿管全切及输尿管口膀胱袖套状切除术10例、后腹腔镜肾部分切除术3例、Anderson-Hynes肾盂成形术1例、肾蒂淋巴管离断术7例、腹腔镜和后腹腔镜活体亲属供肾切取术各1例、肾上腺部分或单纯肿瘤切除术78例、肾上腺全部切除术71例、输尿管切开取石术17例。记录手术时间、手术中失血量、肠道功能恢复时间及并发症，将结果与传统开放手术和国外学者的腹腔镜手术结果进行比较，对数据进行统计分析。

6 cases of urethostenosis, 2 cases of urotithiasis and 1 case of urethral valves were cured one time. They were followed up from 10 months to 6 years and no dysuria occurred. 2 cases of external plank shedding after ureteropelvioplasty were treated with a placement of internal plank through the renal fistulization. The placement and evulsion of internal plank were carried out one time in 8 cases of ureteric calculi (the length of one calculi was as long as 4cm) and 12 cases of ureteropalsty. In 5 cases of upper remotion of internal plank, 4 cases were pulled out successfully and one failed to draw out. The effect is satisfactory to treat urological diseases by means of ureteroscopy in children.

结果 6例尿道狭窄、2例尿道结石、1例尿道瓣膜均一次性治愈，随访10个月~6年，无排尿异常。2例肾盂输尿管成形术后外支架管脱落经肾造瘘口放置内支架；8例输尿管结石（1例石街长约4cm）、12例输尿管成形术后内支架置入和／或拔出均一次完成。5例内支架上移中4例顺利拔出，1例失败、结论输尿管镜对小儿尿路系统大部分疾病的处理有满意效果。

Methods The data of 16 cases of ureteral polyps were reviewed and discussed. 2 cases were treated with nephroureterectomy; 10 cases with local resection plus pyeloplasty or ureteral reimplantation; 4 cases with polyps resection plus basement fulguration.

回顾分析16例原发性输尿管息肉患者的临床资料，其中2例行肾输尿管大部切除术，10例行病变输尿管切除加肾盂成形术或输尿管再植术，4例行息肉切除加基底电灼术。

Rusults In 11 cases, 1 case was underwent nephroureterectomy, 3 cases local resection plus pyeloplasty, 1 case local resection plus ureteroureterostomy, 4 cases polyps resection plus basement fulguration, 2 cases polypous basement resection under ureteroscopy.

结果 11例患者中，1例行肾与输尿管大部切除，3例行输尿管病变段切除肾盂成形术，1例病变段切除输尿管再吻合术，4例行息肉切除加基底电灼，2例输尿管镜下基底部钳除。

Results:Successful rate of ureteroscopic lithotomy is 98.4%;12 patient of upper ureter stone received ESWL because of stone entering the renal pelvis,and 3 cases complicated ureteral perforation;11 cases ureterostensis and 7 cases ureterocele were cured.

结果：输尿管镜取石成功率98.4%，其中上段12例滑入肾盂改行ESWL，术中并发输尿管穿孔3例，1例改行开放手术；11例输尿管狭窄及7例输尿管囊肿全部治愈，术后随访无狭窄及返流。

The 112 cases review analyses outpatient services are applied curing the clinical data of ureter disease patient through the trans-urethral ureteroscope, and among them cure in next section 97 cases in the middle and lower ureteral stone combination the going on nephralgia, blocking nature kidney, the ballistic lithotripsy etc through the trans-urethral ureteroscope, other is for diagnosis 15 cases URS.

回顾性分析112例急诊应用经尿道输尿管镜术治疗输尿管疾病患者的临床资料，其中经尿道输尿管镜术联合气压弹道碎石术治疗输尿管中下段结石合并持续性肾绞痛、梗阻性肾功能不全、感染等97例。

Results Conservative treatment was carried out for 4 patients, ureteroureterostomy for 7 patients, ureteroneocystostomy for 22 patients, bladder valve-ureter anastomosis for 2 patients, vermiform appendix-ureter replacement for 2 patients, and nephrectomy for 1 patients.

结果 4例行双J管保守治疗，7例(9侧)行输尿管端端吻合术，2 2例行输尿管膀胱再植术，2例行膀胱壁瓣输尿管吻合术，2例行阑尾代右侧部分输尿管术，1例行肾切除术。

Ureteroscopy was applied to treat 1200 cases which incelluded ureteral stones in 1010 cases (146 cases in upper, 344 cases in middle. 520 cases in lower),ureteral strictures in 18 ureteral double catheter stagnation in 38, urethral stricture in 38, bladder calculi in 41, pelvis calculi in 8, ureterovaginal fistula in 5 and others.

其中行输尿管镜治疗者1200例，包括输尿管结石1010例，其中上段结石146例、中段344例、下段520例；输尿管狭窄18例；医源性双J管滞留38例；男性尿道狭窄38例；膀胱尿道结石41例；肾盂结石8例；输尿管阴道漏5例；小儿逆行输尿管插管20例；内支架管置入22例。

RESULTS AND CONCLUSION: Among the 34 cases receiving conservative treatment, 2 got urinary tract infection repeatedly, and 5 got the stenosis of ureterovesical anastomotic stoma.

结果与结论：保守治疗34例中反复尿路感染2例，输尿管膀胱吻合口狭窄5例；手术治疗68例中输尿管与输尿管吻合狭窄2例，输尿管膀胱吻合口狭窄1例和输尿管逆流1例。

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Yang yinshu、Wang xiangsheng、Li decang,The first discovery of haemaphysalis conicinna.

1〕 杨银书，王祥生，李德昌。安徽省首次发现嗜群血蜱。