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摘要

本文就输尿管炎,特别是非特异性输尿管炎的治疗经验作一综述。外伤性放射性输尿管炎将在其他章节讨论。大多数输尿管炎病例是传染性的,可能是由于通常在尿路感染中发现的任何有机体,特别是大肠杆菌、葡萄球菌、链球菌、肠球菌、变形杆菌和脓氰杆菌。它确实是原发性的,但它通常从相关的膀胱炎上升,从肾盂肾炎下降,或由于阑尾炎或输卵管炎等邻近炎性病变的直接传播。感染也可通过淋巴传播到达输尿管,特别是从前列腺和精囊传播。输尿管的任何相关异常,如狭窄、大输尿管、输尿管膨出等,都会自然地诱发感染性输尿管炎。由于输尿管炎很少是原发的,治疗的第一步必须是明确和治愈任何潜在的病变。因此,结石、膀胱炎、肾盂炎等都需要适当的治疗,这本身就会大大改善或治愈输尿管炎,特别是在较急性的病例中。在有狭窄形成的慢性病例中,可能需要扩张甚至切除狭窄的部分。对于狭窄的治疗,我们想强调输尿管支架的作用,认为它的使用是必要的,以保持肾功能。
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[Ureteritis].
We relate our experience about ureteritis, especially non specific ureteritis. The traumatic, radiation ureteritis will be discussed in others chapters. Most cases of ureteritis are infective, and may be due to any of the organism normally found in urinary tract infections, particularly Escherichia Coli, staphylococci, streptococci, enterococci, proteus and pyocyaneus. It is really primary, but it usually ascending from an associated cystitis, descending from pyelonephritis, or due to direct spread from and adjacent inflammatory lesion such as appendicitis or salpingitis. The infection may also reach the ureter by lymphatic spread, particularly from the prostate and seminal vesicles. Any associated abnormalities of the ureter, such as stricture, megaloureter, ureterocele, and so on, will naturally predispose to infective ureteritis. As ureteritis is rarely primary, the first step in treatment must be toward the elucidation and cure of any underlying lesion. Thus calculi, cystitis, pyelitis, and so on, will need appropriate therapy, and this in itself will considerably improve or cure the ureteritis, and specially in the more acute cases. In the chronic cases with stricture formation, dilation or even excision of the stenosed portion may be required. For the treatment of the strictures we want emphasize the role of the ureteral stenting thinking its use is necessary to preserve the renal function.
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[Ureteritis]. [Structure, physiology and physiopathology of the ureter]. [Ureteral malformations in the adult]. [Ureteritis]. [Primary ureteral neoplasia].
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