輸尿管內(nèi)窺鏡手術(shù)是通過(guò)一細(xì)長(zhǎng)的窺鏡,經(jīng)尿道、膀胱、輸尿管口進(jìn)入0.2至0.5cm直徑的輸尿管,連接監(jiān)視設(shè)備后,可以很清晰地觀察到輸尿管內(nèi)的病變,從而通過(guò)工作腔內(nèi)插入的不同器械對(duì)輸尿管疾病進(jìn)行診斷與治療。那么我們應(yīng)該如何處理輸尿管內(nèi)窺鏡手術(shù)并發(fā)癥呢?
Ureteroscopic surgery is through a slender endoscope, through the urethra, bladder, ureteral orifice into the 0.2 to 0.5cm diameter of the ureter, after connecting the monitoring equipment, it can clearly observe the lesions in the ureter, so as to diagnose and treat the ureteral diseases through different instruments inserted in the working cavity. So how should we deal with the complications of ureteroscopic surgery?
1、出血
1. Bleeding
術(shù)后出血常常是有發(fā)生的,也是一種比較常見的并發(fā)癥,嚴(yán)重的還可能會(huì)大出血,這主要由于術(shù)中輸尿管損傷所致,一般較輕,不需特殊處理。如出血較嚴(yán)重,要考慮損傷周圍器官的可能,必要時(shí)行介入治療或開放手術(shù)。
Postoperative bleeding often occurs, is also a common complication, serious may also be massive bleeding, this is mainly due to intraoperative ureteral injury, generally light, do not need special treatment. If the bleeding is serious, the possibility of damage to the surrounding organs should be considered. If necessary, interventional therapy or open surgery should be performed.
2、粘膜撕裂和粘膜下假道形成
2. Mucosal tear and submucosal pseudomeatus formation
這種并發(fā)癥一般不容易出現(xiàn),但是也不是完全沒有,這種并發(fā)癥還是比較好處理掉,一般較輕,可置管保守處理。有時(shí)大的粘膜下假道可引起輸尿管缺血致術(shù)后管腔狹窄、甚至壞死。操作時(shí)應(yīng)盡量動(dòng)作柔和,避免導(dǎo)管、導(dǎo)絲引起粘膜的損傷。
This kind of complication is not easy to appear, but it is not completely absent. This kind of complication is better to get rid of. It is generally lighter, and can be treated conservatively by catheterization. Sometimes, large submucosal pseudomeatus can cause ureteral ischemia, resulting in postoperative lumen stenosis, or even necrosis. The operation should be gentle as far as possible to avoid the injury of mucosa caused by catheter and guide wire.
3、穿孔
3. Perforation
這是一種比較嚴(yán)重也是比較常見的并發(fā)癥,需要足夠的重視,以免嚴(yán)重的后果,這種并發(fā)癥常由于導(dǎo)管、導(dǎo)絲損傷所致。一般置管引流常可解決問(wèn)題。穿孑L后的處理重要的是保持輸尿管的引流通暢,避免尿性囊腫形成。
This is a serious and common complication, which needs enough attention to avoid serious consequences. This kind of complication is often caused by the injury of catheter and guide wire. In general, catheter drainage can often solve the problem. It is important to keep the drainage of ureter unobstructed and avoid the formation of urinary cyst.
以上就是關(guān)于如何處理輸尿管內(nèi)窺鏡手術(shù)并發(fā)癥的一些建議,希望對(duì)大家有所幫助。
The above is about how to deal with the complications of ureteroscopic surgery some suggestions, I hope to help you.