056腹腔镜左输尿管切开取石术（经腰入路）手术视频在线观看，高清免费
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<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><strong style="color: blue;">病史及术式简介：</strong></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">病人</span>2周前因体检<span style="color: black;">发掘</span>双肾极重度积水，行双侧输尿管支架置入，复查KUB： <span style="color: black;">左侧支架位置良好，右侧支架于结石下方折返</span><span style="color: black;">。2周后</span><span style="color: black;">复查CT左肾积水缓解，但肾实质菲薄，所剩功能不多。左侧</span><span style="color: black;">如行输尿管软镜碎石，可能<span style="color: black;">显现</span><span style="color: black;">海量</span>残石排出困难。</span><span style="color: black;">故右侧行输尿管软镜碎石后，</span><span style="color: black;">同期行腹腔镜左侧输尿管切开取石术。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">KUB如下：左输尿管上段约2cm结石，右输尿管中上段约1cm结石，<span style="color: black;">左侧支架位置良好，右侧支架于结石下方折返</span><span style="color: black;">。</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="https://q5.itc.cn/q_70/images03/20240708/92628d707b064b8793ce797d0ad0bf1e.jpeg" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">CT如下：</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">腹腔镜输尿管切开取石术，是一种用于治疗输尿管结石的微创外科手术<span style="color: black;">办法</span>。该术式<span style="color: black;">经过</span>腹腔镜技术，即<span style="color: black;">经过</span>小切口<span style="color: black;">插进</span>腹腔镜来观察和治疗输尿管中的结石问题。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">随着腔内治疗技术的进步，腹腔镜在输尿管结石中的应用<span style="color: black;">逐步</span>减少，输尿管切开取石术的净石率接近100% ，但其创伤<span style="color: black;">很强</span>，故<span style="color: black;">通常</span>不<span style="color: black;">做为</span>首选治疗方式。 </p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">以下将<span style="color: black;">仔细</span>介绍这一手术过程，<span style="color: black;">包含</span>其适应症、术前准备、手术<span style="color: black;">过程</span>以及术后护理等方面。 </p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;">1、</span>适应症：</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">腹腔镜输尿管切开取石术<span style="color: black;">一般</span>用于以下<span style="color: black;">状况</span>： </p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">1、ESWL 、输尿管镜和 PNL 取石失败的输尿管结石；</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">2、合并输尿管或邻近组织其他病变需要<span style="color: black;">同期</span>处理；</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">3、长径＞ 1.5cm, 需行多次 ESWL或输尿管镜治疗，或输尿管扭曲估计 ESWL 及输尿管镜治疗成功可能性极小的病例。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;">2、</span>术前准备：</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">在进行腹腔镜输尿管切开取石术之前，<span style="color: black;">大夫</span>会进行以下准备工作： </p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">1. 临床<span style="color: black;">评定</span>：<span style="color: black;">大夫</span>会进行<span style="color: black;">仔细</span>的临床<span style="color: black;">评定</span>，<span style="color: black;">包含</span>体格<span style="color: black;">检测</span>、病史记录和影像学<span style="color: black;">检测</span>（如CT扫描、X射线或超声波），以确定结石的位置、<span style="color: black;">体积</span>和数量。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">2. <span style="color: black;">麻木</span><span style="color: black;">选取</span>：<span style="color: black;">病人</span><span style="color: black;">一般</span>会接受全身<span style="color: black;">麻木</span>，以<span style="color: black;">保证</span>手术过程中<span style="color: black;">病人</span>不感到任何<span style="color: black;">病痛</span>或不适。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">3. 预防感染：在手术前，<span style="color: black;">病人</span>可能需要接受抗生素预防感染。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">4. 空腹状态：手术前<span style="color: black;">一般</span><span style="color: black;">需求</span><span style="color: black;">病人</span>至少6小时内不<span style="color: black;">摄食</span>或饮水，以准备手术。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;">3、</span>手术<span style="color: black;">过程</span>：</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">腹腔镜输尿管切开取石术<span style="color: black;">一般</span>分为以下<span style="color: black;">过程</span>： </p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">1. <span style="color: black;">麻木</span>：<span style="color: black;">病人</span>接受全身<span style="color: black;">麻木</span>，<span style="color: black;">保证</span><span style="color: black;">病人</span>在手术过程中无痛感。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">2. 切口：在腰部或腹部做3个小切口，大约0.5-2厘米长，用于<span style="color: black;">插进</span>腹腔镜器械。腹腔腔内充入二氧化碳气体，以创建<span style="color: black;">更加多</span>的工作空间。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">3. <span style="color: black;">插进</span>腹腔镜：将腹腔镜<span style="color: black;">插进</span>腹腔或后腹腔空间，以便观察输尿管和结石的位置。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">4. 输尿管定位：游离输尿管，寻找结石嵌顿位置。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">5. 输尿管切开：输尿管上做一个总行小切口，<span style="color: black;">一般</span>为1至2厘米。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">6. 取石或碎石：<span style="color: black;">按照</span>结石的<span style="color: black;">体积</span>和数量，<span style="color: black;">大夫</span><span style="color: black;">能够</span><span style="color: black;">运用</span>特殊工具将结石取出或进行碎石。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">7. 留置输尿管支架：输尿管内留置5-7Fr输尿管支架管，<span style="color: black;">运用</span>可吸收线缝合输尿管切口。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">8. 结束手术：留置腹腔或后腹腔引流管，关闭腰部或腹部切口，纱布覆盖，结束手术。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;">4、</span>术后护理：</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">术后，<span style="color: black;">病人</span>需要进行以下护理和<span style="color: black;">重视</span>事项：</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">1. 观察：<span style="color: black;">病人</span>需要在医院观察一段时间，以<span style="color: black;">保证</span><span style="color: black;">无</span>并发症<span style="color: black;">出现</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">2.<span style="color: black;">病痛</span>管理：术后可能会有轻度<span style="color: black;">病痛</span>，<span style="color: black;">大夫</span>会开具适当的<span style="color: black;">药品</span>来缓解<span style="color: black;">病痛</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">3. 液体摄入：<span style="color: black;">病人</span>被鼓励多喝水，以<span style="color: black;">帮忙</span>冲洗残余结石碎片。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">4. 活动恢复：<span style="color: black;">一般</span>，<span style="color: black;">病人</span><span style="color: black;">能够</span>在术后6小时或<span style="color: black;">次日</span><span style="color: black;">逐步</span>恢复正常活动。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">5. 随访：术后需要<span style="color: black;">定时</span>随访<span style="color: black;">大夫</span>，以<span style="color: black;">保证</span><span style="color: black;">恢复</span>顺利。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">总的<span style="color: black;">来讲</span>，</span>腹腔镜输尿管切开取石术是一种安全且有效的治疗输尿管结石的微创手术<span style="color: black;">办法</span>。<span style="color: black;">经过</span>小切口和腹腔镜技术，<span style="color: black;">能够</span>最小化创伤，减少术后恢复时间，并降低<span style="color: black;">病人</span>的不适感。然而，手术<span style="color: black;">是不是</span>适合特定<span style="color: black;">病人</span>，还需要<span style="color: black;">大夫</span><span style="color: black;">按照</span>个体<span style="color: black;">状况</span>来决定。<span style="color: black;">倘若</span>您或您的亲人面临输尿管结石问题，<span style="color: black;">意见</span>咨询专业<span style="color: black;">大夫</span>以获取<span style="color: black;">仔细</span>的诊断和治疗<span style="color: black;">意见</span>。</p>
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<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">本文出自<span style="color: black;">微X</span>公众号：宋宝林谈泌尿</p>
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