摘要
目的探讨输尿管软镜碎石术后留置输尿管支架管的合理时间。方法回顾性分析2015年6月至2017年6月收治的300例结石患者的病例资料，男162例，女138例。年龄17～82岁，平均36.7岁。肾结石168例，非嵌顿性输尿管上段结石132例。结石长径均〈2 cm。所有患者均采用分体组合式输尿管软镜联合钬激光碎石，术后留置输尿管支架管引流。根据输尿管支架管留置时间将患者分为A组（4周）和B组（2周），每组各150例，比较两组的输尿管支架管相关并发症，以及拔管后1个月的排石效果。结果留置输尿管支架管期间，A组和B组的膀胱刺激症状分别为140例（93.3%）和107例（71.3%），腰腹痛分别为85例（56.7%）和36例（24.0%），肉眼血尿分别为133例（88.7%）和60例（40.0%），差异均有统计学意义（P〈0.05）。拔管后1个月复查CT，A组和B组的净石率（残留结石长径〈3 mm）分别为91.3%（137/150）和89.3%（134/150），差异无统计学意义（P〉0.05）。结论输尿管软镜联合钬激光碎石术治疗非嵌顿性输尿管上段结石和肾结石（结石长径〈2 cm）后，输尿管支架管留置2周安全、有效，不影响净石率，且可减少并发症发生率。
ObjectiveTo investigate the duration of indwelling ureteral stent after the ureteroscopic lithotripsy.Methods300 cases of patients were retrospectively analyzed from June 2015 to June 2017, including 168 with renal calculi and 132 with non-incarcerated upper ureteral calculi. The size of stone is 〈2 cm in diameter. According to the length of time for indwelling ureteral stent, all patients were divided into two groups-150 cases in 14-day group （Group A） and 150 in the 28-day group （Group B） for comparing the complication and outcome, and then received modular flexible ureteroscopic lithotripsy combined with holmium laser. Lastly, 6F ureteral stent was indwelling postoperatively.ResultsComplications happened in both two groups after stenting. There were 140 cases （93.3%） complained of bladder irritation symptoms（LUTS） in Group A, while 107 （71.3%） in Group B; 85 cases （56.7%） suffered from flank or abdominal pain in Group A and 36 （24%） in Group B; gross hematuria happened in 133 cases （88.7%） of Group A and 60 cases （40%） of Group B. As the duration of indwelling ureteral stent extended, the incidence of complications increased, significantly （P〈0.05）. CT scan showed there was no statistical difference in stone-free rate （diameter〈3 mm） of two groups [A group： 91.3%（137/150） vs. B group： 89.3%（134/150）, respectively].ConclusionWith high stone-free rate and low complication incidence, 2-week indwelling ureteral stent is safe for patients suffered from renal calculi or non-incarcerated upper ureteral calculi（diameter〈2 cm）.
作者
邱智
张军晖
张际青
吴栗洋
康宁
张小东
Qiu Zhi;Zhang Junhui;Zhang Jiqing;Wu Liyang;Kang Ning;Zhang Xiaodong(Department of Urology,Beijing Chaoyang Hospital,Capital Medical University,Beijing 100020,China)
出处
《中华泌尿外科杂志》
CAS
CSCD
北大核心
2018年第7期537-539,共3页
Chinese Journal of Urology
关键词
输尿管软镜
输尿管支架管
钬激光
肾结石
输尿管上段结石
Flexible ureteroscope
Double-J ureteral stents
Holmium laser
Renal calculi
Upper ureteral calculi
