不同输尿管长度测量法在双J管留置中的应用  

Comparison of different ureteral length measurement methods in the indwelling of double-J stent after ureteroscopy

作　　者：王永传[1] 毕玉行 任安吉[1] 伦晓璐 都靖[1] 周海军[1] 王凯[1] 于志勇[1] 刘稳顺 沈腾 邵怡[2] WANG Yongchuan;BI Yuhang;REN Anji;LUN Xiaolu;DU Jing;ZHOU Haijun;WANG Kai;YU Zhiyong;LIU Wenshun;SHEN Teng;SHAO Yi(Department of Urology,Weifang Traditional Chinese Medicine Hospital,Weifang 261041;Department of Urology,Shanghai Jiaotong University Affiliated First People s Hospital,Shanghai 200080,China)

机构地区：[1]潍坊市中医院泌尿外科,山东潍坊261041 [2]上海交通大学附属第一人民医院泌尿外科,上海200080

出　　处：《现代泌尿外科杂志》2023年第2期106-110,共5页Journal of Modern Urology

基　　金：潍坊市科技发展计划(No.2019YX017);潍坊市卫生健康委员会科研计划(No.WFWSJK-2021-032)。

摘　　要：目的探讨不同输尿管长度测量法在输尿管镜手术后留置双J管时的应用情况。方法前瞻性分析2018年7月—2020年12月潍坊市中医院输尿管镜手术后留置双J管的患者260例,将患者随机分为身高计算组、CT测量组、KUB组、输尿管镜体测量组,分别采用身高计算法、CT测量法、腹部X线平片(KUB)测量法和术中输尿管镜体测量法计算输尿管长度,根据结果选择合适长度的双J管。术后第1天和拔管前分别行KUB检查了解双J管位置。患者留置双J管术前和拔管前分别完成输尿管支架相关症状问卷(USSQ)、泌尿系症状评分、下尿路症状(LUTS)、疼痛评分、血尿评分以及生活质量评分等。结果4组患者的年龄、性别、身高、输尿管侧别和泌尿系症状评分等相关指标差异无统计学意义(P>0.05),4种方法测得的输尿管平均长度分别为(21.5±1.0)、(21.5±1.8)、(23.8±1.3)、(21.7±1.8)cm,其中身高计算组、CT测量组、输尿管镜体测量组3组间差异无统计学意义,3组与KUB组之间差异有统计学意义(P<0.01)。输尿管镜体测量组中理想的输尿管支架长度留置比例为76.9%,优于其他3组。术后双J管留置时间7~42 d(平均29.8 d)。拔除双J管前输尿管镜体测量组USSQ评分为(14.1±1.5)分,优于其他3组(P<0.05);四组的尿频、尿急、夜尿、血尿、生活质量评分、疼痛视觉模拟评分比较,输尿管镜体测量组优于其他3组(P<0.05)。结论术中输尿管镜体法测量输尿管长度简便、易行,个体化地指导留置理想长度的双J管较其他方法更加准确,能有效减少双J管留置引起的下尿路刺激症状等并发症。Objective To investigate the application of different ureteral length measurement methods in the indwelling of double-J stent.Methods Clinical data of 260 patients with double-J stent indwelling after ureteroscopic surgery during Jul.2018 and Dec.2020 were prospectively analyzed.The patients were randomly divided into height calculation group,CT measurement group,KUB group and ureteroscopic measurement group.The length of ureter was calculated accordingly and the appropriate length of double-J stent was selected.KUB was performed on the first day after operation and before extubation to determine the position of double-J stent.The patients completed the ureteral stent-related symptom questionnaire(USSQ),urinary symptom score,lower urinary tract symptom(LUTS)score,pain score,hematuria score,and quality of life score before and after double-J catheter placement.Results There were no significant differences in age,gender,height,side of stent and urinary symptom score among the four groups(P>0.05).The average lengths of the ureters measured by the four methods were(21.5±1.0)cm,(21.5±1.8)cm,(23.8±1.3)cm and(21.7±1.8)cm,respectively.There were no significant differences among the height calculation group,CT measurement group and ureteroscope group,but there was significant difference between the three groups and the KUB group.The ideal ureteral stent length indwelling ratio in the ureteroscopic group was 76.9%,which was better than that in the other three groups.Postoperative indwelling time was 7-42 d(mean 29.8 d).The USSQ score of the ureteroscopic group before extubation was(14.1±1.5),which was lower than that of the other three groups(P<0.05).The ureteroscopic group was better than the other three groups in the comparison of frequency and urgency of urination,nocturia,hematuria,quality of life score,and pain score(P<0.05).Conclusion Intraoperative ureteroscopic measurement of the ureteral length is a simple and feasible method in guiding the indwelling of double-J stent to reduce ureteral stent related symptom

关 键 词：输尿管长度测量 双J管 输尿管支架相关症状 

分 类 号：R691.4[医药卫生—泌尿科学]