输尿管镜钬激光碎石后双J管留置时间与并发症研究

Complications and indwelling time of double-J ureteral stents after ureterscopic holmium-laser lithotripsy

目的:探讨输尿管镜钬激光碎石后双J管留置时间与并发症的关系。方法:根据入院时间将170例患者随机分成2组(留置4周及2周),观察其拔除双J管前后并发症发生。结果:拔除双J管前,2组患者中出现尿路刺激征为81例(93%)和51例(61%)P<0.01,肉眼血尿均为100%,尿路感染71例(82%)和39例(47%)P<0.01,腰部及侧腹痛为26例(30%)和10例(12%)P<0.05,拔管前双J管钙盐沉积为23例(26%)和9例(11%),P<0.01。拔除双J管后2周尿路刺激征为3例(3.4%)和2例(2.4%),镜下血尿9例(10%)和6例(7%),尿路感染7例(8%)和3例(4%),腰部及侧腹痛均为0例,拔管后以上资料无统计学意义。结论:输尿管镜下钬激光后缩短双J管的留置时间可以减少术后尿路刺激征、尿路感染、腰痛等并发症的发生,拔除双J管后不会增加相关并发症。

Objective：Evaluate the relationship of complications and indwelling time of double-J ureteral stents after ureterscopic holmium-laser lithotripsy. Methods：170 patients were divided into two groups randomly. groupⅠ（stents indwelling 4 weeks）,groupⅡ（stents indwelling 2 weeks）.Complications of two groups were compared. Results：During the indwelling time,two groups presented urinary irritative sypmtoms were 81（93%）and 51（61%）P〈0.01,infection were 71（82%）and 39（47%）P〈0.01,flank pain were 26 （30%）and 10（12%）P〈0.05,encrustation were 23（26%）and 9（11%）,P〈0.01 respectively,hemaurine were both 100% in two groups. Two weeks after removing the Double-J stents,urinary irritative sypmtoms were 3 （3.4%）and 2 （2.4%）,microscopic hematuria were9 （10%）and 6（7%）,infection were 7（8%）and 3（4%）,flank pain were 0 in two groups,there were no significant statistically differences between the two groups. Conclusion：For the patients who received ureterscopic holmium-laser lithotripsy,shortening indwelling time could be safe and decrease urinary irritative sypmtoms,hemaurine,infection and flank pain.