小儿清醒状态下带线导管法移除双J管的可行性分析  

Noncystoscopic removal of retained double J stents in awake children using a wire-guided catheter:A retrospective study from a single-center

作　　者：张家华 唐达星[1] ZHANG Jiahua;TANG Daxing(Department of Urology,Children’s Hospital of Zhejiang University,Hangzhou 310000,China)

机构地区：[1]浙江大学医学院附属儿童医院泌尿外科,浙江杭州310000

出　　处：《温州医科大学学报》2024年第11期885-888,共4页Journal of Wenzhou Medical University

摘　　要：目的:探讨小儿于清醒状态下进行带线导管法移除双J管的可行性。方法:收集2019年11月至2020年11月在浙江大学医学院附属儿童医院接受清醒状态下行带线导管法移除双J管62例患儿的临床资料,男44例,女18例。取管时男孩采用自尿道外口注入奥布卡因凝胶进行表面浸润麻醉镇痛,女孩不进行表面浸润麻醉镇痛,取管方法采用硅胶导尿管远端穿牵引线,带线导管入膀胱后旋转导管盲法套住双J管后取管。记录导尿套取次数,≤5次视为取管成功;>5次视为操作失败。术后2周对取管成功患儿进行电话随访。结果:总体成功率93.5%(58/62)。男性患儿组成功率93.2%(41/44),女性患儿组成功率94.4%(17/18)。术后随访,17例女性患儿均无明显不适主诉;男性患儿中,7.3%(3/41)存在一过性排尿疼痛,2.8%(1/36)术后出现发热性尿路感染,2.4%(1/41)患儿存在一过性尿潴留。结论:小儿清醒状态下带线导管法移除双J管成功率高,术后并发症发生率在可接受范围,女婴较为适用。Objective:To explore the feasibility of removing double-J stent in awake pediatric patients using the wire-guided catheter technique,and summarize relevant practical experiences.Methods:This study retrospectively analyzed clinical data of pediatric patients who underwent the wire-guided catheter technique for the removal of double-J stents while awake in our hospital from November 2019 to November 2020.Boys received surface infiltration anesthesia and analgesia with lidocaine gel injected from the external urethral orifice,while girls did not undergo surface infiltration anesthesia and analgesia.The stent removal procedure involved inserting a traction wire through the distal end of the silicone catheter,and after inserting the catheter into the bladder,rotating the catheter to loop the catheter around the double-J stent for removal.The number of attempts required to capture the stent with the catheter was recorded,with five or fewer attempts considered a successful removal while more than five attempts considered a failed procedure.A follow-up phone call was made two weeks post-operation to the patients who had the stent successfully removed.Results:A total of 62 patients underwent stent removal,including 44 males and 18 females,with an overall success rate of 93.5%(58/62).When stratified by gender,the success rate for males was 93.2%(41/44)and for females was 94.4%(17/18).Postoperative follow-up showed no significant complaints among the 17 girls who underwent successful catheter removal.Among boys,7.3%(3/41)experienced transient urinary pain,2.8%(1/36)developed febrile urinary tract infection,and 2.4%(1/41)experienced transient urinary retention.Conclusion:This method of removing double-J stents in awake children has high success rate and acceptable rate of postoperative discomfort symptoms.It is more suitable for infants,especially for female infants.

关 键 词：儿童 输尿管双J管 麻醉 肾积水 

分 类 号：R45[医药卫生—治疗学]