采用导丝引导交替钳夹法为接受后腹腔镜输尿管切开取石术的患者置入双J管的效果  

Effect of double J tube placement in patients undergoing retroperitoneal laparoscopic ureterolithotomy using guidwire-guided alternate clamp method

作　　者：王磊 力威 李乾 王苏贵 张先云 WANG lei;LI Wei;LI Gan;WANG Sugui;ZHANG Xianyun(Department of Urology,Huai'an Hospital Affiliated to Xuzhou Medical University,Huai'an 223002)

机构地区：[1]徐州医科大学附属淮安医院泌尿外科,江苏淮安223002

出　　处：《当代医药论丛》2021年第5期6-8,共3页

摘　　要：目的:探讨并分析对输尿管上段结石患者进行后腹腔镜输尿管切开取石术时采用导丝引导交替钳夹法为其置入双J管的效果。方法:选择2017年4月至2019年9月期间在徐州医科大学附属淮安医院泌尿外科进行后腹腔镜输尿管切开取石术的32例输尿管上段结石患者作为研究对象。在这些患者入院后,对其均进行后腹腔镜输尿管切开取石术,术中均采用导丝引导交替钳夹法为其置入双J管,然后观察其置管的时间、双J管留置的位置、术后拔管的时间及术后发生并发症的情况。结果:这32例患者术中均一次性留置双J管成功,其置管的时间为3〜9 min,平均置管时间为5 min。术后2〜3 d对其进行腹部X线平片检查的结果显示,其中有1例患者双J管的肾盂端回缩入输尿管上段,其余患者双J管留置的位置均正常。术后1个月左右这32例患者均在膀胱镜下顺利地拔除双J管,术后对其进行半年的随访显示,其肾积水均明显改善,且均未出现输尿管狭窄、漏尿等并发症。结论:在对输尿管上段结石患者进行后腹腔镜输尿管切开取石术时,采用导丝引导交替钳夹法为其置入双J管的效果显著,能保证其一次性置管成功,且其术后的并发症较少,置管的安全性较高。Objective:To investigate and analyze the effect of double J tube placement in patients with upper ureteral calculi during retroperitoneal laparoscopic ureterolithotomy with guide wire guided alternating clamp method.Methods:A total of 32 patients with upper ureteral calculi who underwent retroperitoneal laparoscopic ureterolithotomy in the Department of Urology,Huai'an Hospital Affiliated to Xuzhou Medical University from April 2017 to September 2019 were selected as the subjects.After admission,all of these patients underwent retroperitoneal laparoscopic ureterolithotomy.During the operation,double J tubes were placed by guidwire guided alternating clamp method.Then,the time of catheterization,the indwelling position of double J tubes,the time of postoperative extubation and postoperative complications were observed.Results:All the 32 patients were successful in one-time indwelling double J tubes,the time of indwelling was 3-9 min,and the average time of indwelling was 5 min.The results of plain abdominal X-ray examination 2〜3 days after the operation showed that the renal pelvis end of the double J tube was retracted into the upper part of the ureter in 1 patient,and the indwelling position of the double J tube was normal in the other patients.About 1 month after the operation,all the 32 patients were successfully removed under cystoscope,and the follow-up for half a year after the operation showed that the hydronephrosis was significantly improved,and no ureteral stricture,leakage and other complications occurred.Conclusion:In the retroperitoneal laparoscopic ureterolithotomy for patients with upper ureteral calculi,the replacement of double J tube with guide wire guided alternating clamp method has a significant effect,which can ensure the success of one-time catheterization,and the postoperative complications are less,and the safety of catheterization is high.

关 键 词：输尿管上段结石 后腹腔镜输尿管切开取石术 导丝引导交替钳夹法 双J管 

分 类 号：R693[医药卫生—泌尿科学]