输尿管软镜碎石术前是否留置双J管的临床分组对照分析

发布时间：2018-11-26 08:26

【摘要】：目的:对比分析术前是否留置双J管对行输尿管软镜碎石术患者的疗效,安全性及经济和时间成本方面的影响。方法:回顾性地对2014年10月至2016年1月58例行输尿管软镜碎石术的结石患者进行分组对照分析。每组29例,一组入院完善术前准备后直接行输尿管软镜碎石术,记为A组。另一组于入院当日局麻下予留置输尿管双J管,第2天观察无异常后予以办理出院,2周后行输尿管软镜碎石术记为B组。放置输尿管软镜通道鞘困难者予扩张输尿管,仍不成功者则改行经皮肾镜取石术或体外碎石术。对两组患者软镜通道鞘放置成功率,住院时间,住院费用,术中术后并发症,术后1个月后结石清除率等数据进行统计分析比较。结果:本课题58例患者中55例均成功I期行输尿管软镜碎石术,两组患者术中均未出现输尿管撕脱、穿孔及大出血等并发症。两组在其它术后并发症方面比较,差异无统计学意义。软镜通道鞘放置成功率分别为A组25/29(86.20%)、B组29/29(100%)差异比较无统计学意义;I期碎石术成功率A组26/29(89.65%)、B组29/29(100%)差异比较无统计学意义。术后1个月结石清除率A组26/29(89.65%)、B组29/29(100%)差异比较无统计学意义。住院天数比较,A组10.03±4.11天,B组(B组住院时间为两次住院时间累计)12.17±2.75天,P=0.0240.05差异比较有统计学意义差异比较无统计学意义。结论:输尿管软镜碎石术术前可无需常规预先留置双J管2周,手术安全有效、不增加手术并发症,但需具备输尿管扩张器械等条件及技术,并需要高年资经验丰富临床医生主刀完成手术。
[Abstract]:Objective: to compare the effects of double J tube before operation on the efficacy, safety, economy and time cost of ureteral soft lithotripsy (Ureteroscopic lithotripsy). Methods: 58 patients with calculi underwent ureteral soft lithotripsy from October 2014 to January 2016 were analyzed retrospectively. 29 cases in each group were treated with soft ureteroscopic lithotripsy after complete preoperative preparation. The other group was treated with indwelling ureteral double J tube under local anesthesia on the day of admission, and was discharged from hospital after observation on the second day. After 2 weeks, the ureteral soft endoscopy lithotripsy was recorded as group B. The dilated ureter was placed in the ensheathing of soft ureteroscope, and the patients who still failed were treated with percutaneous nephrolithotomy or extracorporeal lithotripsy. The success rate of soft channel sheath placement, hospitalization time, hospitalization cost, intraoperative and postoperative complications, stone clearance rate 1 month after operation and so on were statistically analyzed and compared between the two groups. Results: 55 of 58 patients were successfully treated with soft ureteroscopic lithotripsy. There were no complications such as ureteral avulsion, perforation and massive hemorrhage in both groups. There was no significant difference in other postoperative complications between the two groups. The successful rate of soft channel sheath placement was 25 / 29 (86.20%) in group A (86.20%) and 29 / 29 (100%) in), B group respectively. The success rate of stage I lithotripsy was 26 / 29 (89.65%) in group A (89.65%) and 29 / 29 (100%) in), B group. The stone clearance rate of group A was 26 / 29 (89.65%) and 29 / 29 (100%) of), B at 1 month postoperatively. The days of hospitalization were 10.03 卤4.11 days in group A and 12.17 卤2.75 days in group B, respectively. Conclusion: the procedure of ureteral soft lithotripsy without routine indwelling double J tube for 2 weeks is safe and effective, and does not increase the complications of the operation, but the ureteral dilatation apparatus and other conditions and techniques are needed. And needs a high-age experience clinician to complete the operation.
【学位授予单位】：福建医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R699

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