双J和单J输尿管内支架对患者症状和生活质量影响的研究  

The Effects of Single-J and Double-J Ureteral Stent on Postprocedural Symptoms and Quality of Life

作　　者：戚德峰[1] 曾国华[1] 王露萍[1] 袁坚[1] 单帜昌[1] 李逊[1] 吴开俊[1] 

机构地区：[1]广州医学院第一附属医院微创外科中心,广东广州510230

出　　处：《广州医学院学报》2009年第3期38-41,共4页Academic Journal of Guangzhou Medical College

摘　　要：目的:探讨输尿管双J和单J内支架管对治疗后患者侧腹痛、下尿路症状和生活质量的影响。方法:本研究包括40例成人经皮肾取石(PCNL)术后放置输尿管内支架管的患者。病人随机分为相同数量的2组,组1放置单J输尿管内支架管,近端位于肾脏下盏,下端跨过骶髂关节上缘未进入膀胱。组2放置双J输尿管内支架管,近端位于肾脏下盏,远端在膀胱内。支架管置入25～40 d后病人回答一份关于侧腹痛、排尿困难、尿急、以及生活质量的问卷。结果:活动时侧腹痛,组1有18例(90%),组2有19例(95%),两组差别无显著性(P>0.05)。组1有2例(10%)、组2有14例(70%)有轻度的侧腹痛,多在排尿过程中出现。两组在疼痛程度上差别有显著性(P<0.001)。组1有1例(5%)有排尿困难,组2有3例(15%)有重度排尿困难(P<0.001)。组1有4例(20%)有尿急症状,组2有17例(85%)有中重度尿急症状(P<0.001)。组1的病人报告生活质,仅有1例(5%)感到中度的苦恼,而组2中有5例(25%)感到中、重度苦恼(P<0.001)。结论:输尿管支架管与腰痛和下尿路症状有关。留置内支架管有活动时腰痛。双J内支架管较单J内支架管的患者更容易出现排尿时腰痛、尿急、排尿困难和生活质量的降低。Objective： To evaluate the effect of Single-J and Double-J ureteral stents on postprocedural flank pain, lower urinary-tract symptoms, and quality of life. Patients and. Methods： The study included 40 adult patients who retained unilateral Single-J or Double-J ureteral stents after PCNL. They were randomized into two equal groups. Group 1 had Single-J stents, with the proximal end in the lower calix and the distal end crossing sacroiliac joint upper margin, but no entering the bladder. Group 2 had double-J stent with the proximal end in the lower calix and the lower end in the bladder. Patients answered a questionnaire regarding flank pain, dysuria, and urgency as well as quality of life after 25 N40 days of stenting. Results： Eighteen patients （90%） of group 1 and 19 （95%） of group 2 had active flank pain. There was no significant difference in the degree of flank pain in the two groups（P 〉0.05）. 2 patients （10%） of group 1 and 14 （70%） of group 2 had mild flank pain,especially during urination（P 〈0.001 ）. Moderate dysuria was reported by 1 patients （5%） in group 1 and severe dysuria 3 patients （ 18% ） in group 2 （ P 〈0.001 ）. Moderate urgency was reported by 4 patients （20%） in group 1 and severe urgency in 17 （85%） in group 2 （P 〈0.001 ）. A mild quality of life was reported by patients in group 1, among whom moderate bother was noted by 1 （5%） compared with group 2,in which moderate to severe bother was reported by only 5 patients （25%） （P 〈0.001 ）. Conclusion： Ureteral stents are associated with flank pain and lower urinary-tract symptoms. The flank pain become worse, especially action. The flank pain of urination,urgency and dysuria as well as a worse quality of life were significantly more common in the patients who had Double-J stents than Single-J.

关 键 词：输尿管内支架 症状 生活质量 

分 类 号：R85[医药卫生—航空、航天与航海医学]