两种输尿管导管留置方式在输尿管镜治疗感染性输尿管结石中的应用  

The Application of Internal and Para-calculous Ureteral Catheterization in the Ureteroscopic Lithotripsy for Infected Ureteral Stones

作　　者：谢杰[1] 王强东[1] 董振佳 肖旭[1] 谢永峰[1] XIE Jie;WANG Qiang-dong;DONG Zhen-jia;XIAO Xu;XIE Yong-feng(Department of Urology,Huaiyin Hospital of Huaian,Huaian 223300,Jiangsu,China)

机构地区：[1]江苏省淮安市淮阴医院泌尿外科,淮安223300

出　　处：《中国现代手术学杂志》2018年第4期295-297,共3页Chinese Journal of Modern Operative Surgery

摘　　要：目的探讨内置输尿管导管与旁置输尿管导管在输尿管镜钬激光碎石术治疗感染性输尿管结石的应用效果。方法 2015年2月～2017年1月我院收治感染性输尿管结石患者72例,随机分为两组,各36例,分别采用内置输尿管导管输尿管镜碎石术(内置组))和旁置输尿管导管输尿管镜碎石术(旁置组)。比较两组围手术期结果、结石清除率及术后并发症。结果内置组手术时间短于旁置组,并发症发生率低于旁置组,差异均有统计学意义(P <0. 05),而两组碎石时间、结石清除率、术后短时低热(<38. 5℃)及高热(> 38. 5℃)率比较均无统计学差异(P> 0. 05)。两组术后均无输尿管穿孔、黏膜撕脱发生。结论输尿管镜内置输尿管导管与旁置输尿管导管钬激光碎石术治疗感染性输尿管结石疗效相当,但内置输尿管导管碎石手术时间短,并发症少,安全有效,值得推广。Objective To investigate the effect of internal intubation and para-calculous ureteral catheterization during the ureteroscopic holmium laser lithotripsy for infected ureteral calculi. Methods From February 2015 to January 2017, a total of 72 cases with infected ureteral calculi treated by ureteroscopic holmium lithotripsy in our hospital were randomly divided into two groups： 36 cases were intubated ureteral catheter internally （as the internal intubation group）, and 36 cases were inserted ureteral catheter para-calculi （as the adjacent intubation group）. The peri-operative index, stone clearance rate and complication rate were compared between the two groups. Results The operation time was obviously shorter and the complication rate was remarkable lower in the internal intubation group than those in the adjacent group, and the differences were statistically （ P 〈0.05）. There was no statistical difference in lithotripsy time, stone-free rate, lower-grade fever and hyperpyrexia of pyemia between the two groups. No ureteral perforation and mucous membrane avulsion were found. Conclusion Both internal and adjacent ureteral catheterization can achieve similar effects during ureteroscopic laser lithotripsy, but the internal catheterization has shorter operation time and less complication, and it is deserved to popularize.

关 键 词：输尿管结石 感染 输尿管镜检查 输尿管导管 碎石术  钬激光 

分 类 号：R693.4[医药卫生—泌尿科学]