术前留置双J管时间对经输尿管软镜治疗肾结石的疗效影响

鲁向阳; 李文亮; 李春明

doi:10.13201/j.issn.1001-1420.2020.02.005

术前留置双J管时间对经输尿管软镜治疗肾结石的疗效影响

- 鹤壁煤业集团有限公司总医院泌尿外科(河南鹤壁, 458000)

详细信息

通讯作者: 鲁向阳,E-mail:lxbao0955@163.com

中图分类号: R692.4

收稿日期: 2019-02-13

Efficacy of preoperative indwelling time of double J tube on renal calculi treated by retrograde intrarenal surgery

- Department of Urology, General Hospital of Hebi Coal Industry Group Co., Ltd, Hebi, Henan, 458000, China

More Information

Corresponding author: LU Xiangyang, E-mail: lxbao0955@163.com

Received Date: 13 February 2019

摘要

摘要: 目的:研究留置双J管时间对肾结石患者行输尿管软镜治疗(RIRS)清石率、并发症及患者疼痛的影响。方法:选取2015年9月~2018年9月我院肾结石患者152例进行前瞻性研究,采用随机数字表法均分为两组各76例,均采用RIRS进行治疗,术前常规留置双J管,观察组留置时间为1周,对照组为2周,比较两组手术时间、住院时间、术后3d及1个月结石清除率、术后疼痛、输尿管壁损伤以及其他并发症发生情况。结果:观察组手术时间高于对照组,差异有统计学意义(P<0.05),两组术后3 d结石清除率分别为71.05%和65.79%(P>0.05),术后1个月结石清除率分别为97.37%和93.42%(P>0.05);两组住院时间、术后疼痛及输尿管壁损伤差异无统计学意义(P>0.05);观察组术后发热及尿源性脓毒症发生率低于对照组,结石残留、血尿和输尿管损伤发生率高于对照组,差异均无统计学意义(P>0.05)。结论:RIRS术前常规留置双J管1周可导致较大结石手术时间较留置2周时明显延长,但对结石清除率和并发症发生率均未产生明显影响,因此临床根据患者病情合理缩短双J管留置时间具有一定可行性。
- 肾结石 /
- 输尿管软镜碎石术 /
- 双J管 /
- 留置时间 /
- 清石率 /
- 疼痛
Abstract: Objective: To study the effects of indwelling time of double J tube on stone clearance rate, complications and pain in patients with upper urinary tract calculi treated by retrograde intrarenal surgery(RIRS). Method: A total of 152 patients with renal calculi in our hospital from September 2015 to September 2018 were selected for prospective studies and evenly divided into two groups according to the random number table methods, with 76 cases in each group. All patients were treated with RIRS and given routine preoperative double J tube indwelling, and the indwelling time was 1 w in observation group and 2 w in control group. The operative time, hospital stay and stone clearance rate at 3 d and 1 month after operation and occurrence of postoperative pain, ureteral wall injury and other complications were compared between the two groups. Result: The operative time in observation group was longer than that in control group(P<0.05), and the stone clearance rates at 3 d after operation were 71.05% and 65.79% respectively(P>0.05). The stone clearance rates at 1 month after operation were 97.37% and 93.42% respectively(P>0.05). There was no significant difference in the hospital stay, postoperative pain or ureteral wall injury between the two groups(P>0.05). The incidence rates of postoperative fever and urinary sepsis in observation group were lower than those in control group while the incidence rates of residual stones, hematuria and ureteral injury were higher than those in control group(P>0.05).Conclusion: Routine indwelling double J tube before RIRS for 1 w can lead to a significant prolongation of operative time for larger stones compared with 2 w of indwelling, but it has no significant effects on stone clearance rate or incidence rates of complications. Therefore, it has certain feasibility in the shortening of indwelling time of double J tube according to the patient's condition in clinical practice.
- renal calculi /
- retrograde intrarenal surgery /
- double J tube /
- indwelling time /
- stone clearance rate /
- pain

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