Angus D G, Webb D R
Department of Urology, Royal Melbourne Hospital, Melbourne, Vic., Australia.
Eur Urol. 1988;14(4):287-90. doi: 10.1159/000472961.
Early experience with the rigid ureteroscopy has identified two regions of the ureter that can be difficult to negotiate, the first at the vesicoureteric junction and the second anterior to the iliac bifurcation. Placing the patient in varying degrees of lithotomy has been proposed to overcome these problems. In this study the effects of these alterations of hip flexion on the course of the ureter have been studied by radiographs in patients undergoing ureteroscopy. The lower ureter was demonstrated to possess two curves, an upper curve at the iliac bifurcation which straightens with increasing degrees of lithotomy and a lower vesical curve in the pelvis which is unaltered by patient position. These findings and their clinical significance are described.
早期使用硬性输尿管镜的经验表明，输尿管有两个部位较难通过，第一个是膀胱输尿管连接处，第二个是髂血管分叉前方。有人提出通过改变患者截石位的角度来克服这些问题。在本研究中，通过对接受输尿管镜检查的患者进行X线摄影，研究了髋关节屈曲角度改变对输尿管走行的影响。结果显示，输尿管下段有两个弯曲，一个是在髂血管分叉处的上段弯曲，截石位角度增加时该弯曲变直；另一个是盆腔内的下段膀胱弯曲，患者体位改变对其无影响。本文描述了这些发现及其临床意义。
