肾结石输尿管软镜碎石术后不同双J管留置时间对并发输尿管石街的治疗价值  

Clinical value of different double-J tube indwelling time in the treatment of ureteral stone-street complications after flexible ureteroscope lithotripsy

作　　者：叶友新[1] 邢金春[1] 刘荣福[1] 陈斌[1] 王惠强[1] 郑嘉欣[1] 

机构地区：[1]厦门大学附属厦门第一医院泌尿外科,361003

出　　处：《中国医师进修杂志》2016年第2期131-134,共4页Chinese Journal of Postgraduates of Medicine

摘　　要：目的分析肾结石患者在输尿管软镜碎石术后不同双J管留置时间对并发输尿管石街的治疗价值。方法选择64例实施输尿管软镜钬激光碎石术的肾结石患者，术后均并发输尿管石街；依据不同双J管留置时间分为术后2周拔除双J管组（观察组）及带双J管排石组（对照组），每组32例，对比分析两组患者术后的排石情况及并发症情况。结果观察组排石成功率较对照组明显增高［100.0%（32/32）比65.6%（21/32）]，结石排净时间较对照组明显缩短[（26.4 ± 6.6） d比（45.3 ± 10.9）d]，医疗费用较对照组降低[（768.4 ± 152.6）元比（1262.3 ± 156.8）元］，膀胱刺激征及肉眼血尿的发生率均为15.6%（5/32 ），明显低于对照组的90.6%（29/32）、100.0%（32/32），差异有统计学意义（P〈0.05）；而两组肾绞痛发生率比较差异无统计学意义（P〉0.05）。结论针对肾结石患者在输尿管软镜碎石术后2周拔除双J管的方案，较带双J管排石的方案对术后并发输尿管石街排石的成功率要增高，还能减少尿路刺激征及肉眼血尿等术后并发症，且医疗费用也降低。Objective To investigate the clinical value of different double-J tube indwelling time in the treatment of ureteral stone-street complications after flexible ureteroscope lithotripsy. Methods Clinical data of 64 kidney calculi patients with ureteral stone-street complications after flexible ureteroscope holmium laser lithotripsy were retrospectively analyzed. The patients were divided into observation group （extubating the double-J tube 2 weeks after the surgery） and control group （retaining the double-J tube） with 32 cases in each group. The calculi clearance results and complication were compared between 2 groups. Results The success rate of stone removal in observation group was significantly higher than that in control group： 100.0% （32/32） vs. 65.6% （21/32）, the calculi elimination time was significantly shorter than that in control group： （26.4 ± 6.6） d vs. （45.3 ± 10.9） d, the treatment cost was significantly lower than that in control group： （768.4 ± 152.6） yuan vs. （1 262.3 ± 156.8） yuan, the incidences of irritation symptoms of bladder and macroscopic hematuria were significantly lower than those in control group： 15.6% （5/32） vs. 90.6% （29/32） and 15.6% （5/32） vs. 100.0% （32/32）, and there were statistical differences （P 〈 0.05）. There was no statistical difference in incidence of renal colic between 2 groups （P 〉 0.05）. Conclusions Removing the double-J tube 2 weeks after flexible ureteroscope lithotripsy results in higher stone clearance rate and less complications compared with retaining the double-J tube. It can reduce the occurrence of irritation symptoms of bladder, macroscopic hematuria and treatment cost.

关 键 词：肾结石 输尿管镜 输尿管石街 双J管 

分 类 号：R699[医药卫生—泌尿科学]