输尿管软镜联合钬激光碎石术后双J管留置时间与并发症研究  

Complication and indwelling time of Double-J ureteral stents after flexible ureteroscopy(FURS) and holmium laser lithotripsy

作　　者：高子剑[1] 刘龙[1] 孙永明[1] 段中阳[1] 李昕[1] 

机构地区：[1]沈阳军区总医院泌尿外科,辽宁沈阳110840

出　　处：《安徽医药》2014年第8期1478-1480,共3页Anhui Medical and Pharmaceutical Journal

摘　　要：目的研究输尿管软镜联合钬激光治疗碎石术后双J管留置时间与并发症关系。方法将该院从2011—2013年收入的90例肾结石患者(结石<2.0 cm)随机分成2组均行输尿管软镜联合钬激光治疗碎石术。术后观察分析2组留置双J管时间(留置2周和4周)与并发症发生情况的关系。所有患者记录在其拔除双J管前并发症的发生;分别于拔除双J管后1周和1月复查尿常规;拔管后1个月复查彩超、腹部平片检查残石率,并行99Tcm-DTPA核素肾图检查,记录患侧肾脏肾小球滤过率(GFR)。结果 2组均出现不同程度的并发症,拔除双J管前2组患者出现下尿路刺激症状(LUTS)分别为33例(70.2%)和40例(93.0%),腰腹痛分别为13例(27.7%)和21例(48.8%),肉眼血尿分别为36例(76.6%)和42例(97.7%),双J管上移分别为0例(0.0%)和2例(4.7%),拔管管壁钙盐沉积或拔管困难分别为4例(8.5%)和11例(25.6%)。并发症的发生率随留置时间延长均明显升高,差异有统计学意义(P<0.05)。拔除双J管1个月后复查彩超及腹部平片,提示无泌尿系结石残留,或残留结石直径<3 mm,2组的结石残石率无统计学意义。2组患者拔管后1周及1个月复查尿常规大致正常。2组比较,患侧肾脏的肾小球滤过率(GFR)无统计学意义(P>0.05)。结论输尿管软镜联合钬激光碎石术后留置双J管时间2周较安全有效,减少并发症发生的同时不影响残石清除及肾功能的恢复。Objective To evaluate the relationship of complication and indwelling time of Double-J ureteral stents after flexible ureteroscopy（FURS） and holmium laser lithotripsy. Methods Ninety patients with renal calculi（ 2. 0 cm） were randomized into two groups who were admitted to General Hospital of Shenyang Military Command from 2011 to 2013,group Ⅰ（stents indwelling 2 weeks）and groupⅡ（stents indwelling 4 weeks）. Complications of the two groups were compared. The symptoms of these two groups during and after ureteral stents indwelled were observed and compared. A follow-up by urinalysis was done 1 week and 1 month after removal of Double-J. A follow-up by Color Dupplex Sonography and KUB was done 1 month after removal of Double-J to evaluate the rate of residual stone. And99Tcm-DTPA scintigraphy was done 1 month after removal of Double-J to record the affected kidney GFR. Results The two groups had complications more or less. In group Ⅰand group Ⅱ repectively,there were lower urinary tract symptom（ LUTS） 33（70.2%）and 40（93.0%）,flank pain 13（27.7%） and 21（48.8%）,hemaurine 36（76.6%） and 42（97.7%）,Double-J moving 0and 2（4. 7%）,encrustation or dysextraction of Double-J 4（8. 5%） and 11（25. 6%）. With the prolonged retention time,the incidence of the complications were significantly increased with statistical significance（P〈0. 05）. The Color Dupplex Sonography and KUB were done 1 month after removal of Double-J,No residual stone or stone＇s diameter 〈3 mm was found. In the two groups,the rate of residual stone was not statistically significant. Routine urinalysis which was taken 1 week and 1 month after removal of Double-J was not abnormal. GFR was not statistically significant between 2 groups（ P〈0. 05）. Conclusions After flexible ureteroscopy（FURS） and holmium laser lithotripsy,shortening postoperative indwelling time（2 weeks） of Double-J internal ureteral stents could be safe. This could decrease the incidence of complications,which will

关 键 词：输尿管软镜 双J管 钬激光 

分 类 号：R699.2[医药卫生—泌尿科学]