硅胶外支架外引流与双J管内引流在肾积水手术中的应用比较

周云; 柴红超; 王静茹

doi:10.13201/j.issn.1001-1420.2021.04.012

硅胶外支架外引流与双J管内引流在肾积水手术中的应用比较

- 1. 河北省儿童医院泌尿外科(石家庄, 050000);
- 2. 河北医科大学第四医院胃肠外科
基金项目:
河北省卫生厅科研基金项目(No:20150571)

详细信息

通讯作者: 柴红超,E-mail:sompg6@163.com

中图分类号: R692.2

收稿日期: 2020-05-16

Application of external drainage with silica gel external stent and internal drainage with double J tube in hydronephrosis surgery

- 1. Department of Urology, Hebei Children's Hospital, Shijiazhuang, 050000, China;
- 2. Department of Gastrointestinal Surgery, Fourth Hospital of Hebei Medical University

More Information

Corresponding author: CHAI Hongchao, E-mail: sompg6@163.com

Received Date: 16 May 2020

摘要

摘要: 目的:探讨硅胶外支架外引流与双J管内引流在肾积水手术中的应用效果。方法:选取2015—2016年我院泌尿外科收治的肾积水患儿160例,并随机分为硅胶外支架外引流组(外引流组)和双J管内引流组(内引流组),每组80例。两组患儿分别采取两种不同的引流方式,比较两组的围手术期情况、并发症发生率、肾盂分离度和肾功能。结果:两组手术时间、出血量、医疗费用比较,差异无统计学意义(P＞0.05);内引流组患儿住院时间较外引流组缩短,差异有统计学意义(P＜0.05)。内引流组术后并发症发生率为12.5%,明显低于外引流组的28.75%,差异有统计学意义(P＜0.05)。术后3、6、12个月,两组患儿肾盂分离度均较术前显著减小,差异有统计学意义(P＜0.05);但两组患儿术后12个月的肾盂分离度比较差异无统计学意义(P＞0.05)。术后两组患儿ECT均较术前明显增加,差异有统计学意义(P＜0.05);但两组患儿术后的ECT比较差异无统计学意义(P＞0.05)。结论:硅胶外支架外引流和双J管内引流治疗肾积水均能取得较好的效果,均能够明显改善患儿肾盂分离和肾功能,其中双J管内引流在缩短住院时间和降低术后并发症方面具有一定优势。
- 肾积水 /
- 硅胶外支架 /
- 双J管 /
- 肾盂离断术
Abstract: Objective: To explore the application of external drainage with silica gel external stent and internal drainage with double J tube in hydronephrosis surgery.Methods: From 2015 to 2016, 160 cases of hydronephrosis treated in our hospital were selected and randomly divided into silica gel external stent group(external drainage group) and double J tube group(internal drainage group), 80 cases in each group. The two groups were treated with two different drainage methods, and the perioperative situation, complication rate, renal pelvis separation and renal function of the two groups were compared.Results: There was no significant difference in operation time, blood loss or medical expenses between the two groups(P＞0.05), but the hospitalization time of the internal drainage group was shorter than that of the external drainage group(P＜0.05). The incidence of postoperative complications in the internal drainage group was 12.5%, which was significantly lower than 28.75% in the external drainage group(P＜0.05). At 3, 6 and 12 months after operation, the separation of renal pelvis in the two groups were significantly decreased compared with those before operation, and the difference was statistically significant(P＜0.05). However, at 12 months after operation, the difference between the two groups in the separation of renal pelvis was not statistically significant(P＞0.05). After operation, ECT of the two groups increased significantly compared with those before operation(P＜0.05), but no significant difference was found between the two groups(P＞0.05).Conclusion: Both external drainage with silica gel external stent and internal drainage with double J tube can achieve good results in the treatment of hydronephrosis and significantly improve the separation of renal pelvis and renal function in children. Double J tube internal drainage has certain advantages in shortening hospitalization time and reducing postoperative complications.
- hydronephrosis /
- external silica gel stent /
- double J tube /
- pyelotomy

HTML全文

参考文献(17)

[1]	祖建成,何军,宁锋,等.离断式肾盂成形术对小儿肾积水的治疗及疗效影响因素分析[J].国际外科学杂志,2019,46(1):48-52.
[2]	Dudek-Warcho T,Warcho S,Bombiński P,et al.Pyonephrosis as the first symptom of congenital hydronephrosis in a 6-year old girl[J].Pol Merkur Lekarski,2018,44(262):196-200.
[3]	韩晓敏,陈敏,肖亚军,等.腹腔镜离断式肾盂输尿管成形术治疗UPJO肾积水230例经验总结[J].临床泌尿外科杂志,2019,34(5):24-28.
[4]	关勇,孟庆娅,王欣,等.儿童肾盂输尿管连接部梗阻所致肾积水的腹腔镜治疗疗效分析[J].临床泌尿外科杂志,2019,34(7):16-19,23.
[5]	谢华伟,周辉霞,马立飞,等.两种经脐腹腔镜肾盂成形术治疗儿童肾积水的疗效比较[J].中华小儿外科杂志,2015,36(10):732-735.
[6]	Baas W,O'Connor B,El-Zawahry A.Bilateral hydronephrosis and acute kidney injury secondary to pelvis lipomatosis[J].Can J Urol,2018,25(1):9217-9219.
[7]	吴荣德,刘伟.先天性肾盂输尿管连接处梗阻的诊治现状[J].中华小儿外科杂志,2015,36(10):721-723.
[8]	周云,柴红超,王静茹,等.硅胶外支架与双J管在小儿肾积水手术中的应用比较[J].临床外科杂志,2020,28(2):134-137.
[9]	翟文生,杨濛,袁斌.中医儿科临床诊疗指南·小儿泌尿道感染(修订)[J].中医儿科杂志,2017,13(3):5-9.
[10]	习林云,何大维,刘星,等.腹腔镜下双侧Anderson-Hynes肾盂输尿管成形术治疗UPJO所致肾积水[J].中华小儿外科杂志,2015,36(10):728-731.
[11]	Chiarenza SF,Bleve C,Fasoli L,et al.Ureteropelvic junction obstruction in children by polar vessels.Is laparoscopic vascular hitching procedure a good solution?Single center experience on 35 consecutive patients[J].J Pediatr Surg,2016,51(2):310-314.
[12]	Meng Liu,Zhanli Fu,Qian Li,et al.Delayed renal tissue tracer transit in Tc-99 m-DTPA renography correlates with postoperative renal function improvement in UPJO patients[J].Nucl Med Commun,2015,36(8):833-838.
[13]	陈超,杨体泉,苏成,等.支架管外引流与双J管内引流在小儿离断式肾盂成形术中的应用比较[J].临床小儿外科杂志,2014,13(1):34-38.
[14]	Marques V,Parada B,Rolo F,et al.Intracaval misplacement of a double-J ureteral stent[J].BMJ Case Reports,2018,2018:bcr2017221713.
[15]	陈舜琦.双J管留置时间对泌尿系统结石并发感染临床治疗效果的影响[J].医学临床研究,2018,35(6):1127-1129.
[16]	Kajbafzadeh A,Zeinoddini A,Ebadi M,et al.External extension of double-J ureteral stent during pyeloplasty:inexpensive stent and non-cystoscopic removal[J].Int Urol Nephrol,2014,46(4):671-676.
[17]	于春晓,于泉,秦瑞,等.双J管内引流在妊娠合并输尿管结石的临床应用[J].国际泌尿系统杂志,2018,38(5):726-728.