输尿管镜治疗复杂性输尿管结石留置双J管时间的临床观察

发布时间：2018-07-23 18:02

【摘要】：目的:探讨输尿管镜治疗复杂性输尿管结石术后留置双J管最佳时间。方法:回顾性分析2012年8月至2015年8月,采用输尿管镜配合钬激光治疗复杂性输尿管结石161例。按照术后留置双J管时间不同分为3组:2周组(A组)43例;2~6周组(B组)67例;6周组(C组)51例。比较各组置管相关并发症及拔管后肾积水加重情况,观察留置双J管的最佳时间。结果:C组总体置管相关并发症发生率显著高于A组、B组,差异具有统计学意义(P0.017)。拔管后A组输尿管狭窄率为23.25%(10/43),高于B组[5.97%(4/67)]和C组[5.9%(3/51)],差异具有统计学意义(P0.017),而B组与C组相比差异无统计学意义。结论:复杂性输尿管结石术后置管相关并发症随时间的延长而显著增加,而置管时间过短则发生输尿管狭窄概率增加,观察后认为术后最佳置管时间为2~6周。对于术中发现输尿管黏膜损伤严重者应适度延长双J管留置时间。
[Abstract]:Objective: to investigate the best time of indwelling double J tube after ureteroscopy for complicated ureteral calculi. Methods: 161 cases of complicated ureteral calculi were treated with ureteroscope and holmium laser from August 2012 to August 2015. According to the time of indwelling double J tube after operation, they were divided into 3 groups: group A, 43 cases, group B, 67 cases, group C, 67 cases. The complications associated with catheterization and the exacerbation of hydronephrosis after extubation were compared and the optimal time of indwelling double J tube was observed. Results the incidence of complications associated with catheterization in group C was significantly higher than that in group A (P 0.017). The ureteral stricture rate of group A was 23.25% (10 / 43) after extubation, which was higher than that of group B [5.97% (4 / 67)] and group C [5.9% (3 / 51)]. The difference was statistically significant (P0.017), but there was no significant difference between group B and group C. Conclusion: the complications associated with catheterization of complicated ureteral calculi increased significantly with the prolongation of time, and the probability of ureteral stricture was increased if the time of catheterization was too short. It is considered that the best time of catheterization after operation is 2 ~ 6 weeks. If the ureteral mucosal injury was serious, the retention time of double J tube should be prolonged.
【作者单位】：郑州大学第二附属医院;河南省人民医院;
【分类号】：R699.4

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