摘要
目的探讨输尿管镜体术中直接测量输尿管长度指导上尿路术后留置理想双J管的临床疗效及安全性。方法选择潍坊市中医院2019年1月—2022年6月因上尿路结石接受双J管留置的患者300例,其中276例患者完成随访,24例患者因记录不全或失访退出。其中男200例(72.5%),女76例(27.5%);年龄20~90岁,平均(48.39±13.16)岁;体重42~125 kg,中位体重72 kg;左侧149例(54.0%)、右侧127例(46.0%)。根据术中输尿管镜体测量法选择与输尿管长度最接近的双J管,术后第1天和拔管前分别行KUB检查。留置双J管前和拔管前分别完成输尿管支架相关症状问卷(Ureteral Stent Related Symptoms Questionnaire,USSQ),包括下尿路症状(lower urinary tract symptom,LUTS)、疼痛评分、血尿评分以及整体健康状况评估等。根据身高分组比较不同组间输尿管支架管相关并发症的差异。结果本组患者身高为150~184 cm,平均(168.00±0.77)cm;术中输尿管镜体法测量输尿管长度范围为16.50~26.00 cm,平均(21.89±1.64)cm,其中左侧输尿管平均长度(22.13±1.67)cm,右侧输尿管平均长度(21.61±1.58)cm。留置22 cm双J管183例(66.3%),24 cm双J管79例(28.6%),26 cm双J管14例(5.1%);b型输尿管支架190例(68.8%),5例(1.8%)出现输尿管支架移位。225例(81.5%)术后出现轻度肉眼血尿,105例(38.0%)夜尿≥2次,79例(28.6%)自述有尿急症状。通过患者身高分组比较USSQ及位置良好型输尿管支架差异无统计学意义(P>0.05)。结论术中输尿管镜测量法指导选择理想双J管简单、准确、安全有效。22~24 cm长度输尿管支架管可能更适合于身高<180 cm的大多数中国患者。
Objective To explore intraoperative ureteroscopy measurement in the determination of ideal double J stent length for endourologic surgery to reduce the postoperative ureteral stent related symptoms.Methods Data of 276 patients who accepted double-J ureteral stent indwelling because of upper urinary tract stone or ureteral stricture in Weifang Hospital of Traditional Chinese Medicine from January 2019 to June 2022 were collected.The body height ranged from 150 to 184 cm(mean 168.00±0.77 cm).The age of patients ranged from 20 to 90 yrs(mean 48.39±13.16 yrs).The weight ranged from 42 to 125 kg(mean 72 kg).This study included 200 males(72.5%)and 76 females(27.5%),left side in 149(54.0%)cases and right side in 127(46.0%)cases.The closest double-J ureteral stent was selected according to the measured length,then KUB was performed on the first day after operation and before extubation to understand the position of double-J ureteral stent.The Ureteral Stent Related Symptoms Questionnaire(USSQ),including lower urinary tract symptoms(LUTS),physical pain symptoms,hematuria score,and overall health status were completed before tube placing and extubation respectively.According to the height group,the differences of double J ureteral stent indwelling guided by ureteroscopic measurement among different height groups were further compared.Results The length of ureter measured by ureteroscope during operation was 16.50-26.00 cm(average 21.89±1.64).The average length of left ureter was(22.13±1.67)cm,and the right ureter was(21.61±1.58)cm.Length of 22 cm stents were placed for 183 cases(66.3%),24 cm for 79 cases(28.6%),and 26 cm stents for 14 cases(5.1%).Five cases(1.8%)had ureteral stent displacement,225 cases(81.5%)had gross hematuria,and 105 cases(38.0%)had nocturia for more than 2 times,79 cases(28.6%)described symptoms of urinary urgency,and 190 cases(68.8%)were placed with type b ureteral stent.There was no significant difference between USSQ and b-type ureteral stents in height grouping(P>0.05),so ureteroscopy to guide
作者
毕玉行
王永传
都靖
周海军
任安吉
王凯
伦晓璐
沈腾
于志勇
刘稳顺
袁星辰
邵怡
BI Yuhang;WANG Yongchuan;DU Jing;ZHOU Haijun;REN Anji;WANG Kai;LUN Xiaolu;SHEN Teng;YU Zhiyong;LIU Wenshun;YUAN Xingchen;SHAO Yi(Department of Urology,Weifang Traditional Chinese Medicine Hospital,Weifang,Shandong,261041,China;Department of Urology,First People's Hospital of Shanghai Jiao Tong University)
出处
《临床泌尿外科杂志》
CAS
2023年第11期875-879,共5页
Journal of Clinical Urology
基金
潍坊市卫生健康委员会科研计划(No:WFWSJK-2021-032,WFWSJK-2023-085)
潍坊市科学技术发展计划(No:2022YX017)。
关键词
输尿管长度
双J管
输尿管支架相关症状
ureteral length
double-J ureteral stent
ureteral stent related symptoms
