改良环套式与传统异物钳钳夹式双J管拔管法的疗效比较

Comparison of Clinical Effect of Pipe Extractor of Improved Collar Style and Traditional Foreign Body Forceps in Extubation of Double- J Stent

目的通过与传统异物钳比较,探讨改良环套式拔管器拔除双J管的安全性和可行性。方法选择2013年9月—2014年8月河北医科大学第二医院泌尿外科门诊符合纳入与排除标准有拔除双J管指征的患者120例,采用单盲随机数字表法分为改良组和传统组,各60例。改良组患者采用自制的改良环套式拔管器拔除双J管,传统组患者采用传统异物钳钳夹式拔除双J管,比较两组患者的操作时间、实施操作后首次排尿出现肉眼血尿例数、尿常规中红细胞计数及操作中、操作后10 min疼痛数字评分法(NRS)评分。结果改良组操作时间为(65.1±12.1)s,传统组为(63.6±17.8)s,差异无统计学意义(t=0.48,P>0.05)。改良组首次排尿出现肉眼血尿41例(68.3%),传统组51例(85.0%),差异有统计学意义(χ2=4.66,P<0.05)。改良组尿常规红细胞计数为(38.9±13.7)×106/L,传统组为(89.5±26.6)×106/L,差异有统计学意义(t=13.10,P<0.05)。改良组操作中NRS评分为(4.9±1.6)分,传统组为(6.9±0.9)分,差异有统计学意义(t=8.44,P<0.05)。改良组操作后10 min NRS评分为(1.7±1.0)分,传统组为(3.1±0.7)分,差异有统计学意义(t=8.88,P<0.05)。结论改良环套式拔管器较传统异物钳钳夹式拔除双J管易于操作,安全性高,对患者痛苦小、损伤小,便于临床推广应用。

Objective To analyze the safety and efficacy of pipe extractor of improved collar style and traditional foreign body forceps in the extubation of double- J stent. Methods A total of 120 patients who were admitted to the Department of Urology of the Second Hospital of Hebei Medical University from September 2013 to August 2014 were selected. All the patients met the inclusion and exclusion criteria and were with indication of extubating double- J stent. Single blind random number table was used to divide the patients into improved group and traditional group with each group 60 cases. The improved group used self- made pipe extractor of improved collar style to extubate the double- J stent,while the traditional group used traditional foreign body forceps to extubate the double- J stent. The operation time,number of patients with gross hematuria in the first urination after extubation,red blood cell count（ RBC） in the urine routines,numeric rating scale（ NRS） during operation and 10 min after operation of the two groups were compared. Results The operation time of the improved group and traditional group was（ 65. 1 ± 12. 1） s and（ 63. 6 ± 17. 8） s,respectively,and the difference was not statistically significant（ t = 0. 48,P〉0. 05）.41 patients（ 68. 3%） in the improved group had gross hematuria in the first urination after extubation,while the number in the traditional group was 51（ 85. 0%）,and the difference was statistically significant（ χ2= 4. 66,P〈0. 05）. The RBC in the urine routines of the improved group and traditional group was（ 38. 9 ± 13. 7） × 10^6/ L and（ 89. 5 ± 26. 6） × 10^6/ L,respectively,and the difference was statistically significant（ t = 13. 10,P〈0. 05）. The NRS during operation of the improved group and traditional group was（ 4. 9 ± 1. 6） score and（ 6. 9 ± 0. 9） score, respectively, and the difference was statistically significant（ t = 8. 44,P〈0. 05）. The NRS 10 min after operation of the improved group and traditional group was（ 1. 7 ± 1. 0）score and（ 3. 1 ± 0. 7） score,respectively,and the difference was statistically significant（ t = 8. 88,P〈0. 05）. Conclusion Compared with the traditional foreign body forceps,the pipe extractor of improved collar style is very safe and cheap,and the patients suffer less pain and injury as well,and therefore it can be widely promoted in clinic.