摘要目的 总结输尿管镜手术损伤的原因及治疗和预防措施.方法 回顾性分析1270例经尿道输尿管镜钬激光碎石术中47例发生输尿管损伤患者的临床资料.结果 1270例输尿管镜手术患者中共有47例(3.70％)发生输尿管损伤,其中输尿管口严重撕裂21例(1.65％),黏膜下假道11例(0.86％),输尿管穿孔12例(0.94％),发生输尿管断裂3例(0.23％).输尿管损伤患者留置D-J管42例,开放性手术5例.结论 输尿管损伤和并发症的处理与操作者的经验密切相关,术前加强培训、熟练操作技巧是减少手术失败率和并发症的关键,出现损伤后应及时发现并妥善处理.

abstractsObjective To summarize the causes,treaments and prevention of ureteral injury caused by ureteroscopy.Methods The clinical data of 47 cases of ureteral injuries in 1270 cases of ureteroscopy with holmium laser lithotripsy were reviewed retrospectively.Results Totally 47 patients had ureteral injuries,of whom,21 cases(l.65％ ) had severe dilaceration of the ureteral orifice,11 cases (0.86％) of false passage,12 cases (0.94％ ) of ureteral perforation,3 cases (0.23％ ) of completed avulsion of the ureter.Forty-two paitents were treated by indwelling doubl J sents and 5 paitents by open surgery.Conclusions The management of ureteral injury and complication and were closely related with the expericence of the operator,strengthening preoperative training,the surgical technique is the key to reduce the failue rate and complications in ureteroscopy,and the injury should be detected timely and properly handled.