输尿管镜术后膀胱输尿管反流临床观察（附152例报告）

摘要

目的：：观察输尿管镜手术对膀胱输尿管反流的影响,探讨其发生机制。方法：选取152例行输尿管镜手术的患者,术前、术后分别行排尿性膀胱造影摄片,术后首次检查于拔除双 J 管后当天进行,若发现反流,3~6个月后再次复查。结果：152例患者术前均无膀胱输尿管反流,术后3~5周拔除双 J 管后当天行膀胱造影,1例发生Ⅰ级反流,5个月后复查恢复正常。结论：输尿管镜术后早期可出现膀胱输尿管反流,但发生率极低,程度轻；单次手术多次进镜不会增加术后反流的发生率；膀胱造影不必作为术后常规随访检查项目。%Objective:To investigate vesicoureteral reflux (VUR)after ureteroscopy and discuss the possible mechanism.Methods:1 52 patients undergoing ureteroscopy were chosen randomly.Each patient respectively accept-ed micturae cystourethrography (MCU)examination preoperatively and postoperatively.The first postoperative MCU was done on the day after removal of the catheter.If VUR was found this time,MCU reexamination was done 3-6 months later.Results:In all 1 52 cases,no VUR was found in preoperative MCUs.In the first postoperative MCU examination,VUR of degree Ⅰ occurred in one case,and recovered 5 months later.Conclusions:Early VUR after ureteroscopy happens rarely,lightly and temporarily.Multiple ureteroscopic insertions into ureter during single operation could not increase the risk of VUR occurrence.It's not necessary to make MCU as a routine follow-up item after ureteroscopy.