摘要
目的探究输尿管碎石术后输尿管内支架管(双J管)的最佳拔管时间,既保证双J管起到支架引流作用,又尽可能减少置管相关并发症的发生。方法采用前瞻性研究方法,对输尿管镜碎石术后留置双J管患者,依据纳入标准,按照术后拔管时间,随机分为A(3d)、B(7d)、C(14d)、D(28d)4组,每组30例,记录患者拔管前置管相关并发症,拔管后并发症改善情况及新增症状,统计分析各组之间的差异,以确定双J管最佳拔管时间。结果拔管前各组均有置管相关并发症发生,D组总并发症发生率显著高于其他各组(P<0.05),以肉眼血尿、膀胱刺激症、管周结痂为明显;而拔管后腰痛以A组最为常见(16.7%)。结论随着双J管留置时间的延长,双J管引起的并发症显著增加,而过早拔除双J管则可能引起腰痛;拔管时间为术后7～14d为宜。
【Objective】To investigate the optimal time for removal of indwelling ureteral stent (double J stent) following ureteroscopic lithotripsy (URL), when the supporting and draining effect of the stent could be guaranteed, as well as the double J related complications would be reduced as far as possible.【Methods】120 patients who met the preset inclusion criteria with indwelling double J stents after URL were prospectively and randomly divided into A (3-day), B (7-day), C (14-day) and D (28-day) group according to their postoperative extubation time respective- ly; 30 patients in each group. Both stenting-related complication before extubation, and improvement of these com- plications as well as newly -developed symptoms after extubation were recorded, and their difference between the four groups was statistically analyzed, to determined the optimal removal time of double J stent. 【Results】Adverse effects of double J stent placement were found in all groups. Total incidence of complications were statistically high- er in D group (P <0.05). Gross hematuria, lower urinary tract symptoms (LUTS) and incrustation formation were morecommonly seen in D group, meanwhile lumbar pain after extubation was developed most frequently in A group (16.7%).【Conclusions】Findings in present study suggest that overall complications of double-J stent increase along with prolongation of their indwelling time; howerver, premature removal of double J stent may caused lumbar pain due to inadequate drainage of urine resulted from inflammatory edema of ureteral wall. The optimal time to remove double J stent after ureteroscopic lithotripsy may be 7~14 days.
出处
《中国内镜杂志》
CSCD
北大核心
2012年第11期1147-1150,共4页
China Journal of Endoscopy
基金
第三军医大学临床科研课题(No.2007XG068)
关键词
输尿管镜碎石术
双J管
并发症
拔管时间
ureteroscopic lithotripsy
double J stent
complication
extubation time
