输尿管镜术后双J管异位的原因及其防治(附15例报告)

Reason and treatment precaution of double J ureteral stent ectopic after operation of ureteroscopic(report of 15 cases)

目的总结输尿管镜术后双J管异位的原因及防治。方法回顾性分析2003年6月至2009年3月输尿管镜术中放置双J管术后异位的15例:上移异位3例,下移异位11例,泌尿系外异位1例。结果3例上移异位患者均通过输尿管镜取出双J管;11例下移异位患者给予提前膀胱镜取出双J管;1例泌尿系外异位双J管于膀胱镜下重新逆行置管。结论留置双J管是防治输尿管镜术后并发症的首选方式;正确掌握适应证、双J管长度、拔管时间、术中操作等可以有效避免严重并发症的发生。术后紧密追踪观察是减少双J管异位的关键。

Objective To summarize the reason and treatment precaution of double J ureteral stent ectopic after operation of ureteroscopic. Methods From June 2003 to March 2009,the clinical data of 15 cases with double J ureteral stent ectopic of afteroperation of ureteroscopic were retrospectively analyzed,including upward move（3 cases）,down move（11 cases）,out urology ectopia（1 case）. Results The 3 cases of upward move were unloaded by ureteroscopic. The 11 cases of down move were unloaded by Cystoscopic. The 1 case of out urology ectopia was placement do double J ureteral stent immediately by cystoscopic. Conclusions It is the first line treatment precaution of indwelling of double J ureteral stent for double J ureteral stent ectopic after operation of ureteroscopic. Severe complications can be avoided if indications are adopted correctly;lengths of double J are pertinence;time of unload are pertinence;operations are pertinence. Key point of precaution of double J ureteral stent ectopic is tracking observation afteroperations.