后腹腔镜输尿管上段切开取石术中两种放置输尿管支架方法的对比分析  

Retroperitoneal Laparoscopic Ureteral Incision and Analysis of Two Kinds of Ureteral Stents Placement Method Contrast Stone Taken During the Operation

作　　者：高飞[1] 刘清学[1] 彭洪[1] 刘建洪[1] 李万华[1] 凌思果 杨军[1] 

机构地区：[1]攀枝花市攀钢集团总医院泌尿外科,四川攀枝花617063

出　　处：《四川医学》2015年第5期650-652,共3页Sichuan Medical Journal

摘　　要：目的探讨后腹腔镜输尿管上段切开取石术中输尿管支架的放置方法。方法 2006年7月至2014年5月共完成后腹腔镜输尿管上段切开取石术428例,术中均放置输尿管支架。预先将输尿管支架分别向两端穿好导丝,经输尿管切口将其向远端插入至膀胱,拔出远端导丝,再向近端插入至肾盂,拔出近端导丝52例(方法一);将输尿管支架上端卷曲部分留下约1cm,其余部分剪掉,将具有可塑性钢丝从输尿管支架直行处侧孔插入至顶端,用操作钳辅助将全部输尿管支架置入输尿管内,包括卷曲部分,操作钳夹在输尿管支架与钢丝分叉处,倒退回抽钢丝,输尿管支架倒退进入输尿管-肾盂内,"倒退法"放置输尿管支架376例(方法二)。结果所有患者输尿管支架放置均成功,输尿管均用4-0可吸收线间断缝合,其中方法一耗时7~12min,方法二耗时25S^3min。所有患者拔出引流管时间、拔出导尿管时间、漏尿时间以及术后平均住院日差异无统计学意义(P>0.05)。结论 "倒退法"放置输尿管支架操作简单易学、耗时明显减少,大大降低了该手术的难度,值得推广。Objective To investigate the retroperitoneal laparoscopic ureteral incision method of placing Ureteral stents stone surgery. Methods In July 2006 to May 2014, after the completion of the 428 cases of laparoscopic incision in the upper u- reter stone extraction for intraoperative are placed D-J tube. In advance to D-J tube to wear good thread on both ends respectively, the ureter incision insert it to the distal to the bladder, pull out the remote thread, proximally insert again to the renal pelvis ,pull out the proximal godet 52 cases （method a） ;Part D-J tube top crimping left about 1 era, cut off, the rest will have plasticity steel wire from D-J tube straight side hole insert to the top, with operating forceps auxiliary all D-J tube placement within the ureter,in- cluding curly part, operating clamped in D-J tube and steel bifurcation, a throwback to smoke wire, D-J tube back into-in the renal pelvis,ureter ＂backward＂ D-J tube placement in 376（method 2）. Results all patients with Ureteral stents p!acement was suc- cessful in all, ureter with 4-0 absorbable suture which（ method 1 ） time of 7 - 12min, method 2 takes 25s - 3rain. All the patients pull out the drainage time, catheter extraction time urine leakage in time and the mean hospital stay after operation had no statisti- cally significant difference （ P 〉 0. 05 ）. Conclusion ＇ setback＇ placed Ureteral stents easy and simple operation, time is signifi- cantly reduced, greatly reduces the operation difficulty, worthy of promotion.

关 键 词：后腹腔镜 输尿管上段结石 输尿管支架 放置方法 

分 类 号：R699[医药卫生—泌尿科学]