双J管置入术治疗上尿路狭窄38例临床效果观察

Clinical observation of double-J stent implantation for treatment of upper urinary stricture in 38 cases

目的 探讨双J管置入术治疗上尿路狭窄的临床效果.方法 选取2010年3月～2011年4月在本院因上尿路狭窄做双J管置入术的患者38例,观察双J管留置期间的效果、不良反应和并发症.结果 38例患者均一次性成功置入双J管,在双J管置入过程中无一例患者出现输尿管穿孔损伤的情况.在置管期间,双J管起到了很好的内引流尿液和支撑扩张输尿管的功能.其中,18例患者出现尿痛、腰痛、膀胱刺激症和血尿症状,进行对症抗炎治疗后症状消失,其他患者未出现任何不良反应和并发症.治疗6个月后,对38例患者进行B超复查,发现所有患者的肾积水症状均得到改善,腰部胀痛和尿路感染等症状得到缓解,未出现任何不良反应.其中3例肿瘤导致上尿路狭窄的患者肾功能得到改善,生存质量有所提高.结论 在上尿路狭窄的治疗中使用双J管置入术可以明显改善患者的临床症状,双J管起到了很好的内引流和支撑作用.该方法操作简便、安全有效、不良反应和并发症少,是治疗上尿路狭窄的首选方法,值得临床推广应用.

Objective To discuss about the clinical efficacy of double-J stent implantation for treatment of upper uri- nary stricture in 38 cases. Methods 38 cases of upper urinary tract stricture and implanted with double J tube in our hospital from March 2010 to April 2011 were selected and were observed of efficacy,adverse reactions and complica- tions during the period of double J tube indwelling. Results 38 patients were successfully implanted double J tube for one time without ureteral perforation situation.During the period of double J tube indwelling,it played sound function of drainage of urine and supported the expansion of the metanephric duct.18 patients had symptoms like dysuria,back pain,bladder irritation and hematuria,while after anti-inflammatory treatment the symptoms disappeared.Other patients didn＇t show any adverse reactions or complications.The 38 cases of patients were measured with B-type uhrasonogra- phy six months after treatment,the results showed all patients with hydronephrosis symptoms were improved,symptoms like lower back pain and urinary tract infections were also alleviated without any adverse reactions.Three cases of up- per urinary stricture were caused by tumors,the patients＇ renal functions were improved and the qualities of life were improved after double-J stent implantation. Conclusion Double-J stent implantation for treatment of upper urinary stricture has sound efficacy by playing a very good internal drainage and supporting role.The method is simple,safe and effective with fewer side effects and complications,is the preferred method for the treatment of upper urinary stricture, and is worthy of clinical application.