多根双J管置入在输尿管狭窄腔内钬激光切开中的应用体会  

Clinical Experience of Multiple Double-J Tubes Placement in Intraluminal Holmium Laser Incision of Ureteral Stricture

作　　者：赵永录 张兴盛 宋广智 张斌 顾鹏守 刘国淦 陈路晓 Zhao Yonglu;Zhang Xingsheng;Song Guangzhi(Department of Urology, People’s Hospital of Wuwei, Wuwei 733000, China)

机构地区：[1]甘肃省武威市人民医院泌尿外科,武威733000

出　　处：《中国微创外科杂志》2022年第6期467-471,共5页Chinese Journal of Minimally Invasive Surgery

基　　金：武威市科技计划项目(ww170325)。

摘　　要：目的探讨输尿管狭窄腔内钬激光切开后多根双J管置入的应用价值。方法2017年1月~2020年12月,61例良性输尿管狭窄行腔内狭窄切开,其中23例行经皮肾穿刺输尿管镜下钬激光顺行切开(同期行肾结石碎石取石8例),38例行输尿管镜下逆行切开,均放置2或3根F6双J管。结果61例手术均顺利完成,手术时间30~78 min,平均53 min。术中无严重并发症,术后血尿1例,腰痛伴体温≥38.5℃5例,明显尿频尿急3例。12周后拔除双J管,继续观察6个月,53例肾积水消失,1例肾积水与术前比较无变化,7例肾积水逐渐加重,其中3例再次在输尿管镜下扩张置管。一期有效率86.9%(53/61),二期总有效率91.8%(56/61),拔除双J管后随访12~24个月,(15.8±3.7)月,再未出现肾积水加重。结论输尿管狭窄行腔内钬激光切开后放置多根双J管,安全可行,效果满意。Objective To investigate the efficacy of multiple double-J tubes in intraluminal holmium laser incision of ureteral stricture.Methods From January 2017 to December 2020,61 patients with benign ureteral stricture were received intraluminal treatment.There were 23 patients who underwent percutaneous nephrolithotomy and holmium laser anterograde incision under ureteroscopy(8 patients underwent renal stone lithotripsy simultaneously)and 38 patients underwent retrograde incision under ureteroscope.A total of 2 or 3 F6 double-J tubes were placed in the ureter.Results All the 61 operations were successfully completed.The operation time was 30-78 min,with an average of 53 min.There were no serious complications during the operation.Postoperative hematuria occurred in 1 case,low back pain with body temperature≥38.5℃in 5 cases,and obvious frequent and urgent urination in 3 cases.After 12 weeks,the double-J tubes were removed and the patients were further observed for 6 months.A total of 53 cases of hydronephrosis disappeared,1 case of hydronephrosis had no change compared with that before operation,and 7 cases of hydronephrosis gradually aggravated,3 of which were cured after dilation and catheterization under ureteroscopy.The effective rate of primary operation was 86.9%(53/61),and that of secondary operation was 91.8%(56/61).The patients were followed up for 12-24 months(mean,15.8±3.7 months)after double-J tubes removal.There was no further aggravation of hydronephrosis.Conclusion It is safe and feasible to place multiple double-J tubes in holmium laser incision of ureteral stricture.

关 键 词：多根双J管置入 良性输尿管狭窄 钬激光腔内切开 

分 类 号：R69[医药卫生—泌尿科学]