输尿管内支架管滞留的临床处理和预防  

Clinical Treatment and Prevention of Ureteral Stents Retention

作　　者：张力 邓林 董晓波 王凯[1] 张川[1] ZHANG Li;DENG lin;DONG Xiao-bo;WANG Kai;ZHANG Chuan(Affiliated Fifth People’s hospital of Chengdu university of Traditional Chinese Medicine,Urology department,Sichuan,611130,China)

机构地区：[1]成都中医药大学附属第五人民医院泌尿外科,四川成都611130

出　　处：《承德医学院学报》2022年第4期297-302,共6页Journal of Chengde Medical University

基　　金：四川省卫生与健康委员会经费资助(19PJ017)。

摘　　要：目的探讨分析泌尿系结石术后输尿管支架管滞留及其相关并发症临床处理与预防。方法回顾总结17例输尿管内支架管滞留患者临床资料,并结合相关文献报道进行分析。结果本次研究中17例患者平均年龄51.82±17.98岁,平均留置时间16.06±13.54月。17例患者术前按照FECal分级100%Ⅲ级以上,其中Ⅴ级(7/17,41.2%),Ⅳ级(7/17,41.2%),Ⅲ级(3/17,17.6%)。通过外科干预,所有患者均成功取出输尿管支架管,成功率100%。本次研究对5例患者进行了包裹结石的成分分析,分析率(5/17,29.4%),分析结果显示4例为磷酸钙,另1例为草酸钙。分析患者双J管滞留原因主要是对于疾病的认识不足,工作繁忙所致遗忘,同时58.8%的患者希望能够得到医院的督促和提醒避免支架滞留的发生。结论输尿管内镜治疗输尿管支架管滞留是安全、微创、有效的,同时,通过全程化的健康管理机制有助于预防泌尿系结石术后输尿管支架管滞留。Objective Removing remained or forgotten ureteral stents is challenging.We present our experience with heavily encrusted ureteral stents and discuss the endourologic treatment options as well as their effectivity.Methods 17 patients were collected and treated at our clinic.Medical records of the patients were retrospectively reviewed and analyzed.Results Seventeen patients(mean 51.82±17.98 years of age)with forgotten stents(mean 16.06±13.54 months of indwelling).According to the Forgotten-Encrusted-Calcified(FECal)classification,all patients were above grade Ⅲ(100%),including grade Ⅴ(7/17,41.2%),grade Ⅳ(7/17,41.2%),grade Ⅲ(3/17,17.6%).All patients were undergoing the operation and removed the stent successfully.In this study,5 patients(5/17,29.4%)were analyzed for the composition of the stone.Four patients were phosphate calcium and the other one was oxalate calcium.Analysis of the causes of double J tube retention was mainly due to lack of understanding of the disease and forgetting caused by busy work.Meanwhile,58.8% of the patients hoped to be supervised and reminded by the hospital to avoid the occurrence of stent retention.Conclusion Endoscopic treatment of ureteral stent retention is safe,minimally invasive and effective.The whole process of health management is one of the helpful way to prevent stent retention after urological surgery.

关 键 词：输尿管 支架管 滞留 

分 类 号：R699.4[医药卫生—泌尿科学]