输尿管镜结石手术中应用双J管的疗效观察（附84例报告）

Observation on the Effect of Application of Double J Tube in Ureteroscopy Stone Surgery

目的：对输尿管镜结石手术中应用双J管（输尿管支架管）的临床资料进行总结、分析，探讨输尿管镜结石手术中留置双J管指征、留置时间及相关并发症处理。方法：分析2012年1月～2013年12月期间我院泌尿外科84例输尿管镜结石手术中留置双J管患者的临床资料。其中中下段输尿管结石78例，上段输尿管结石6例，双侧输尿管结石4例，合并输尿管息肉10例，合并输尿管狭窄8例，合并上尿路感染（脓肾）5例，均采用进口巴德F5型号双J管，留置时间1周～3个月。结果：术后随访，复查泌尿系CT或KUB（腹部平片）提示输尿管内结石已排尽，统计出现肉眼（镜下）血尿35例，下尿路刺激症状32例，尿路感染14例，移位（滑脱或回缩）3例，双J管管壁晶体物或结石附着12例，输尿管返流2例。结论：双J管适用于输尿管镜结石手术，合理的应用可以有效减少手术并发症发生率，从而提高临床使用的有效率。

Objective：To ureteroscopy stone surgery by double J tube （ ureteral stent ） clinical data were summarized , analyzed, discussed ureteroscopy stone surgery indications for indwelling double J tube, indwelling time and treatment -related complications. Methods：urology clinical data of during January 2012 to December 2013 in our hospital 84 cases with double J tube indwelling ureteros-copy stone surgery were retrospectively analyzed.Under section ureteral calculi in 78 cases, upper ureteral calculi in 6 cases, bilateral u-reteral calculi in 4 cases, combined ureteral polyps in 10 cases, ureteral stenosis merger in 8 cases , the combined urinary tract infection （ pyonephrosis ） in 5 cases, Bard F5 double J tube were used, indwelling time of 1 week -3 months.Results：The postoperative follow-up , review urinary tract CT or KUB （ KUB ） prompted the ureteral stones drained , statistics appear to the gross（ microscopic） hema-turia in 35 cases , 32 cases of lower urinary tract irritation , 14 cases of urinary tract infection, 3 cases of displacement （ slippage or re-traction ） , 12 cases of double J tube wall crystal or stones attached , 2 cases of ureteral reflux.Conclusion：Double J tube suitable for ureteroscopy stone surgery,reasonable application can effectively reduce the incidence of surgical complications , thereby improving effi-ciency in clinical use.