摘要目的 介绍软性膀胱镜下输尿管逆行置管的方法,并评估其可行性及安全性.方法 对拟行逆行肾盂输尿管造影患者112例,按性别随机分为2组,每组56例,其中男31例、女25例;分别行软性膀胱镜和硬性膀胱镜下逆行输尿管置管.比较2组的置管时间、VAS疼痛评分、置管成功率、置管后增加的肉眼血尿人数、置管后发热发生率.结果 软镜下置管55例(98%,55/56)获成功,硬性膀胱镜下53例(95%,53/56)置管成功.2组男性患者间及女性患者间对比,置管时间、成功率差异均无统计学意义(均P＞0.05).2组男性患者间及女性患者间VAS疼痛评分,软性膀胱镜组患者疼痛较硬镜组轻;而同组间女性患者疼痛较男性轻(P＜0.05).置管后增加血尿病例软性膀胱镜组为5例;硬性膀胱镜组14例,差异有统计学意义(P＜0.05).置管后软性膀胱镜组4例出现体温升高(＞37.5℃),硬性膀胱镜组6例,差异无统计学意义(P＞0.05).结论 软性膀胱镜下逆行输尿管置管成功率高,痛苦小,操作安全.

abstractsObjective To introduce a method of retrograde ureterie catheter placement via flexible eystoscope,and to evaluate the feasibility and safety of this method．Methods 112 patients,62 males and 50 females undergoing retrograde ureteropyelography by 2 same physicians in cooperation were randomly divided into two equal groups with 31 males and 25 females each:one group via flexible cystoscope and the other group via rigid cystoscope.The catheterizing time,visual analogue scale(VAS)pain score,gross hematuria rate,and fever rate were compared between these 2 groups.Results Fifty-five patients underwent ureteric catheter placement successfully via flexible cystoscope(98％,55/56),while 53 cases were technically successful by rigid cystoscope(95％,53/56).The inserting time in women patients of the flexible cystoscopy group was(7.6±1.8)min,significantly shorter than that of the men[(8.0±1.8)min,P<0.05].The inserting time in women patients of the rigid eystoscopy group was(7.4±1.5)min,significantly shorter than that of the men[(8.2±1.2)min,P<0.05].However,there were not significant differences in the inserting times in both men and women between these 2 groups(both P>0.05).The VAS pain scores in men and women of the flexible eystoscope group were 3.5 and 2.3 respectively,both significantly lower than those of the rigid cystoscopy group(7.2 and 3.3 respectively,both P<0.05).The gross hematuria rate of the flexible cystoscope group was 8.9％(5/56),significantly lower than that of the rigid cystoscopy group(25.0％,14/56,P<0.05).Four patients had a fever after flexible eystoscopy while 6 cases did after rigid cystoscopy,however,without significant difference between these 2 groups(P>0.05).Conclusions Retrograde placement of ureteric catheter via flexible cystoscope is safe and reliable as rigid cystoscopy.Meanwhile,inserting ureteric catheter via flexible cystoscope causes the patients less pain and less chance of hematuria.