双J管在体外冲击波碎石治疗输尿管中上段结石中的合理应用  

Application of double-J stents in extracorporeal shock wave lithotripsy for the treatment of middle and upper ureteral calculi

作　　者：王曦[1] 蒋远斌[1] 王铀[1] 

机构地区：[1]重庆市中医院泌尿外科,重庆400021

出　　处：《局解手术学杂志》2014年第5期463-465,共3页Journal of Regional Anatomy and Operative Surgery

摘　　要：目的评估留置双J管在体外冲击波碎石治疗输尿管中上段结石中的有效性及安全性,探索双J管的合理应用。方法统计在我院治疗的输尿管中上段结石患者511例,留置双J管后再施行体外碎石患者161例,直接施行体外冲击波碎石患者350例,分为置管和未置管2组。分析2组间结石X光显示定位满意率、碎石效果及不良反应发生率。结果置管组X光结石显示定位满意率高于未置管组(P=0.025)。置管组、未置管组结石清除率比较有统计学意义(P=0.041)。置管组患者血尿、下尿路症状发生率明显高于未置管组(P<0.05)。置管组患者肾绞痛发生率低于未置管组(P=0.001)。结论双J管置入对结石显示及定位有帮助,可提高结石清除率。对直径小于1 cm的输尿管阳性结石,是否置双J管对结石清除率影响不大,但可减少剧烈肾绞痛的发生率。Objective To evaluate the efficacy and safety of double-J stents in extracorporeal shock wave lithotripsy for the treatment of middle and upper ureteral calculi, and to explore the reasonable application of double-J stents. Methods 511 patients with middle and up-per ureteral calculi in our hospital were selected as the statistical objects. 161 patients of the catheter group were indwelled double-J stent be-fore extracorporeal lithotripsy while the other 350 patients in the no-catheter group underwent extracorporeal shock wave lithotripsy directly. The satisfaction rate of X-ray display location, gravel effect, and rate of adverse reaction were compared. Results The satisfaction rate of X-ray display location in the catheter group was higher than the no-catheter group （P=0. 025）. And the gravel effect of the two groups were of statistical significance （P=0. 041）. The incidence of hematuria and lower urinary tract symptoms in the catheter group was significantly high-er than that in the no-catheter group （P〈0. 05）. The incidence of renal colic in catheter group was lower than that in no-catheter group （P=0. 001）. Conclusion Indwelling double-J stents is useful for stones display and localization, and it can improve the stone clearance rate. For ureteral stones whose diameter were less than 1 cm, double-J stents has little influence on the rate of stone clearance, but it can reduce the occurrence of severe renal colic.

关 键 词：体外冲击波碎石 双J管 输尿管中上段结石 

分 类 号：R691.4[医药卫生—泌尿科学]