浅析输尿管镜手术并发症分析与防治孙昌友杨斌【摘要】目的分析討论输尿管镜手术的并发症以及其防治措施。方法回顾性分析160例行输尿管镜手术患者的临床资料，总结分析术中以及术后发生并发症的原因及处理措施。结果术中发生并发症：输尿管穿孔2例（1.25%）；术后发生并发症：肉眼血尿20例（12.50%），结石残留8例（5.00%），发热4例（2.50%），腰痛6例（3.75%），双J管移位2例（1.25%）。2例输尿管穿孔患者因穿孔较小，双J管越过穿孔位置后停止手术，4周后再次行输尿管镜术碎石成功；术后20例患者出现肉眼血尿，使用止血药物后，肉眼血尿均在3d内消失；结石残留患者在术后2周行体外冲击波碎石术，随访2个月，8例患者均排石成功；术后4例患者出现发热，给以抗生素加强抗感染治疗，4例患者均在5d内好转，体温达到正常；6例患者出现腰痛，对腰痛患者行腹部平片检查，4例患者因结石残留引发腰痛，体外冲击波碎石后疼痛缓解，2例患者因双J管扭曲发生疼痛，拔出双J管后疼痛缓解；2例患者发生双J管移位，经输尿管镜取出。结论输尿管镜手术所引发的并发症与医生的操作技术、术中灌注压的大小、双J管的应用以及输尿管的条件有关，熟练的技术以及充分认识各种并发症发生的原因可预防并发症的发生。【关键词】输尿管镜；并发症；防治DOI：10.14163/jki.11-5547/r.2017.02.022BriefanalysisandpreventionandtreatmentofcomplicationsinureteroscopeoperationSUNChang-you，YANGBin.YunnanWenshanStateYanshanCountyPeoplesHospital，Wenshan663100，China【Abstract】ObjectiveToanalyzeanddiscusscomplicationsinureteroscopeoperationandtheirpreventionandtreatmentmeasures.MethodsClinicaldataof160patientsreceivingureteroscopeoperationwereretrospectivelyanalyzed.Causesandmanagementmeasuresforintraoperativeandpostoperativecomplicationsweresummarizedandanalyzed.ResultsIntraoperativecomplicationsincluded2caseswithureteralperforation（1.25%）.Postoperativecomplicationsincluded20caseswithgrosshematuria（12.50%），8caseswithresidualcalculi（5.00%），4caseswithfever（2.50%），6caseswithosphyalgia（3.75%）and2caseswithdoubleJureteralcathetershifting（1.25%）.Duetosmallureteralperforationin2cases，theiroperationceasedafterdoubleJureteralcatheterthroughperforation，followedbysuccessfulureteroscopelithotripsyafter4weeks.20caseswithgrosshematuriareceivedhemostaticsandhaddisappearedgrosshematuriawithin3d.Patientswithresidualcalculireceivedextracorporealshockwavelithotripsyafter2weeks，and2-monthfollow-upshowedsuccessfullithagoguein8cases.4caseswithfeverreceivedenhancedanti-infectiontreatmentbyantibiotics，andall4casesshowedimprovementandnormaltemperaturewithin5d.Abdominalplainfilmexaminationin6caseswithosphyalgiashowed4caseswithresidualcalculi-inducedosphyalgia，whowererelievedbyextracorporealshockwavelithotripsy，and2caseswithdoubleJureteralcathetershifting-inducedosphyalgia，whowererelievedbydoubleJureteralcatheterremoving.DoubleJureteralcathetersshiftingin2caseswereremovedthroughureteroscope.ConclusionComplicationsinureteroscopeoperationarerelatedwithdoctorsoperationtechnique，intraoperativeperfusionpressure，doubleJureteralcatheterandureteralcathetercondition.Practicedtechniqueandfullunderstandingofcomplicationcausescanpreventcomplications.【Keywords】Ureteroscope；Complications；Preventionandtreatment输尿管镜术因微创、疗效显著等优点在泌尿外科手术中被广泛使用，在输尿管疾病的诊疗中有着重要作用，但也存在一定的危险，如技术操作不当、术前评估不充分等原因会引发相应的并发症，影响患者的预后[1]。本文就本院160例输尿管镜手术患者中发生并发症的原因以及防治措施进行总结分析。现报告如下。1资料与方法1.1一般资料选取本院2014年2月～...