嵌顿性输尿管结石腔内碎石后两种支架管留置方法预防术后输尿管狭窄比较  

The method of stent indwelling after intracavity lithotripsy prevents postoperative ureteral stricture

作　　者：黎勇林[1] 刘明[1] 刘玉明[1] 傅发军[1] Li Yonglin;Liu Ming;Liu Yuming;Fu Fajun(Department of Urology,Changsha Central Hospital,Changsha 410004,China)

机构地区：[1]长沙市中心医院泌尿外科,长沙410004

出　　处：《国际泌尿系统杂志》2023年第5期829-832,共4页International Journal of Urology and Nephrology

摘　　要：目的对比研究嵌顿性输尿管结石行腔内碎石后两种支架管留置方法对预防术后输尿管狭窄的作用。方法回顾性收集2015年9月1日至2021年1月1日于本院行手术治疗(输尿管软镜、硬镜、经皮肾镜碎石)的302例输尿管嵌顿性结石患者,根据术后双J管留置根数分为观察组(92例,术后留置两根D-J管4~8周)和对照组(210例,术后留置一根D-J管4~8周)。对比分析两组的术前、术后临床资料以及D-J管拔除后随访1年内的输尿管狭窄发生率。结果两组患者的性别、年龄、体重指数、结石患侧、结石嵌顿段、结石长径、肾积水程度等一般资料比较,差异均无统计学意义(均P>0.05);两组术后的生活质量(QOL)评分、感染发生率、附壁结石发生率、局麻拔管失败率比较,差异均无统计学意义(均P>0.05);观察组的术后输尿管狭窄发生率低于对照组(10.9%vs.20.5%,χ^(2)=4.08,P=0.043)。结论嵌顿性输尿管结石腔内碎石后留置两根F6D-J管4~8周能有效降低术后输尿管狭窄的发生。Objective To compare the effect of two kinds of stent indwelling methods on the prevention of postoperative ureteral stricture after intraluminal lithotripsy for incarcerated ureteral calculi.Methods A total of 302 patients with ureteral incarcerated calculi who underwent surgical treatment(soft ureteroscopy,hard ureteroscopy,percutaneous nephrolithotriptery)in our hospital from September 1,2015 to January 1,2021 were retrospectively collected and divided into the observation group(92 cases,two D-J tubes for 4 to 8 weeks after surgery)and the control group(210 cases,two D-J tubes for 4 to 8 weeks after surgery)according to the number of postoperative indentures.A D-J tube was retained for 4 to 8 weeks after surgery).The preoperative and postoperative clinical data of the two groups and the incidence of ureteral stenosis within 1 year after D-J tube removal were compared.ResultsThere were no significant differences in gender,age,body mass index,stone affected side,stone incarcerated segment,stone length and degree of hydronephrosis between the two groups(all P>0.05).There were no significant differences in quality of life(QOL)scores,incidence of infection,incidence of mural adhesion stones and failure rate of local anesthesia extubation between the two groups(all P>0.05).The incidence of postoperative ureteral stenosis was lower in the observation group than in the control group(10.9%vs.20.5%,χ^(2)=4.08,P=0.043).Conclusions Indwelling two F6 D-J tubes for 4-8 weeks after intraluminal lithotripsy for incarcerated ureteral calculi can effectively reduce the incidence of postoperative ureteral stricture.

关 键 词：输尿管结石 嵌顿性结石 输尿管支架 输尿管狭窄 

分 类 号：R699[医药卫生—泌尿科学]