双“D-J”管在预防复杂性输尿管结石钬激光碎石术后狭窄的应用  

Application of Double“D-J”Stents in the Prevention of Ureteral Stricture after Holmium Laser Lithotripsy for Complicated Ureteral Calculi

作　　者：佟杨 张大田 田洪阳 张强 TONG Yang;ZHANG Da-tian;TIAN Hong-yang;ZHANG Qiang(Department of Urology, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou 121000, Liaoning, China)

机构地区：[1]锦州医科大学附属第一医院泌尿外科,辽宁锦州121000

出　　处：《中国现代手术学杂志》2020年第2期141-145,共5页Chinese Journal of Modern Operative Surgery

摘　　要：目的探讨复杂性输尿管结石钬激光碎石术后留置双“D-J”管对预防术后狭窄的临床疗效。方法选取我院2018年6月~2019年6月收治的因复杂性输尿管结石行输尿管镜钬激光碎石治疗的80例患者,采用随机数字法分为研究组(n=40例)及对照组(n=40例),于钬激光碎石术后分别留置双“D-J”管和单根“D-J”管。比较两组患者手术时间、腰痛数字评分、膀胱刺激症、肉眼血尿、结石残留率、输尿管狭窄发生率等指标。结果两组患者手术时间及膀胱刺激症、腰痛评分、血尿、发热等带管期间并发症比较,差异均无统计学意义(P>0.05);拔管4周后两组结石清除率比较,差异亦无统计学意义(P>0.05);拔管后研究组输尿管狭窄发生率为5%,明显低于对照组的22.5%,差异有统计学意义(P<0.05)。结论对于复杂性输尿管结石患者,放置双“D-J”管可有效减少输尿管狭窄的发生,并对带管期间并发症和结石清除率无影响。Objective To investigate the clinical effect of indwelling dual double-J(D-J)stents after holmium laser lithotripsy for the prevention of postoperative ureteral stenosis.Methods 80 patients with complicated ureteral calculi admitted from June 2018 to June 2019 were enrolled and divided randomly into two groups,with 40 cases for each group:After ureteroscopic holmium laser lithotripsy,D-J stents were indwelled in the study group and single D-J stent were indwelled in the control group.The indicators of bladder irritation,digital score of lumbago,gross hematuria,residual stone rate and the incidence of ureteral stricture were compared between the two groups.Results There was no significant difference in the operative time,lumbago score,incidence of bladder irritation,hematuria and fever(P>0.05).No statistical difference was found in the stone-free rate between the two groups 4 weeks after extubation(P>0.05).The incidence of ureteral stenosis was 5%of the study group,and was lower than 22.5%of the control group(P<0.05).Conclusion The placement of dual D-J stents can reduce the occurrence of ureteral stricture effectively for the patients with complicated ureteral calculi,and have no effect to the rate of stone clearance and postoperative complication during the tube period,but further studies are needed to verify.

关 键 词：输尿管狭窄 输尿管结石 碎石术 钬激光 支架 

分 类 号：R693.4[医药卫生—泌尿科学]