探讨肾筋膜扩张器在经尿道输尿管镜手术中的应用价值。

回顾性分析西安医学院第一附属医院泌尿外科自2014年1月至2015年12月收治的50例输尿管下段结石患者，在斑马导丝引导下输尿管镜直视下以8 F筋膜扩张器扩张输尿管壁间段，扩张后行输尿管镜下气压弹道碎石术。

50例结石均一期碎石成功，手术时间（40±9）min。其中男性22例，8例筋膜扩张器扩张输尿管壁间段失败，成功率14/22（63.6%）。女性28例，成功率28/28（100%）。术中未发生输尿管穿孔、假道，输尿管黏膜剥脱、断裂等并发症。术后4例女性、1例男性患者出现发热，予敏感抗生素抗感染治疗后痊愈。术后导尿管留置时间（1.6±0.7）d，双J管留置时间（11±4）d。随访半年未见输尿管狭窄及肾积水加重。

经尿道输尿管镜手术中使用肾筋膜扩张器扩张输尿管壁间段有利于输尿管镜进入，减少输尿管术中损伤，女性成功率高，尤其适合于女性患者。

To explore the clinical value of renal fascia dilator in ureteroscopy.

Dilation of ureter was taken by 8 F fascia dilator in 50 patients who were diagnosed as lower ureteral calculi and underwent ureteroscopic pneumatic lithotripsy in the First Affiliated Hospital of Xi'an Medical University from January 2014 to December 2015. The data were analyzed retrospectively.

All 50 patients were stone-free after the first procedure. Operation time was (40±9) min. Eight men failed when expanded intramural ureter with fascia dilator. The success rate was 14/22 (63.6%). But the success rate was 28/28(100%) in 28 women. No severe complications such as ureteral perforation, false passage, avulsion of the ureter、ureter fracture were occurred. Five patients had fever who were treated with sensitive antibiotic. The catheters were removed (1.6±0.7) days postoperatively. Double J stent were removed on (11±4) days. No ureteral stricture and hydronephrosis were found during 6 monthes follow up.

Fascia dilator can make the entry of ureteroscope easy, can reduce the complications of ureteroscopic pneumatic lithotripsy. Female’s success rate was higher, so this method is especially suitable for the female patients.