输尿管软镜碎石术后留置输尿管支架与输尿管导管的有效性与安全性研究  

Efficacy and safety of indwelling ureteral stent and ureteral catheter after ureteroscopic lithotripsy

作　　者：李海明 唐磊 李钧[1] Li Haiming;Tang Lei;Li Jun(Department of Urology,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京友谊医院泌尿外科,北京100050

出　　处：《中国医刊》2023年第3期298-301,共4页Chinese Journal of Medicine

基　　金：首都卫生发展科研专项项目(首发2020-2-1102)。

摘　　要：目的探讨输尿管软镜碎石术后留置输尿管导管与留置输尿管支架的有效性与安全性。方法回顾性分析2020年6月至2022年2月于首都医科大学附属北京友谊医院行输尿管软镜碎石术的142例泌尿系结石患者(结石直径<2cm)的临床资料,术前均置入输尿管支架对输尿管进行预扩张,根据术后引流方式不同将研究对象分为支架组(留置输尿管支架,96例)和导管组(留置输尿管导管,46例)。比较分析两组患者的手术相关情况,包括手术时间、住院时间和总体治疗费用。术后1个月采用输尿管支架症状调查问卷和结石清除率评价两组患者的临床疗效。比较分析两组患者术后的并发症发生情况。结果两组患者的手术时间和住院时间比较差异均无显著性(P>0.05);支架组患者的总体治疗费用显著多于导管组(P<0.05)。两组患者的结石清除率比较差异无显著性(P>0.05);导管组患者的下尿路症状评分、躯体疼痛症状评分、一般健康情况评分、工作情况评分均显著低于支架组(P<0.05)。两组患者均未发生Clavien-DindoⅢ级及以上并发症,导管组患者的尿频、尿急、尿痛、血尿和尿路感染发生率均显著低于支架组(P<0.05)。结论在术前预扩张的情况下,对于结石直径<2cm的泌尿系结石患者,输尿管软镜碎石术后短期留置输尿管导管与留置输尿管支架均具有良好的结石清除率和安全性,但留置输尿管导管患者的术后并发症发生率更低,且生活质量更高。Objective To explore the efficacy and safety of indwelling ureteral stent and ureteral catheter after ureteroscopic lithotripsy.Method The clinical data of 142 patients with urinary calculi(stone diameter<2cm)who underwent ureteroscopic lithotripsis in Beijing Friendship Hospital,Capital Medical University from June 2020 to February 2022 were retrospectively analyzed.Ureteral stents were implanted before operation to predilate the ureter.According to different postoperative drainage methods,the subjects were divided into stent group(indwelling ureteral stent,96 cases)and catheter group(indwelling ureteral catheter,46 cases).Operation related conditions,including operation time,hospital stay and overall treatment cost,were compared between the two groups.One month after the operation,the clinical efficacy of the two groups was evaluated by the ureteral stent symptom questionnaire and stone removal rate.The postoperative complications of the two groups were compared and analyzed.Result There were no significant differences in operation time and hospital stay between the two groups(P>0.05).The overall treatment cost in stent group was significantly higher than that in catheter group(P<0.05).There was no significant difference in stone removal rate between the two groups(P>0.05).Lower urinary tract symptom score,somatic pain symptom score,general health status score and work status score in catheter group were significantly lower than those in stent group(P<0.05).No Clavien-DindoⅢor above complications occurred in the two groups,and the incidence of urinary frequency,urgency,dysuria,hematuria and urinary tract infection in catheter group was significantly lower than that in stent group(P<0.05).Conclusion In the case of predilation before operation,short-term indwelling ureteral catheter and indwelling ureteral stent after ureteroscopic lithotripsy have good stone removal rate and safety for patients with urinary tract calculi with stone diameter<2cm,but the postoperative complication rate of patients with indwellin

关 键 词：输尿管软镜碎石术 输尿管支架 输尿管导管 并发症 结石清除率 

分 类 号：R69[医药卫生—泌尿科学]