双J管滞留的原因及防治对策

Analysis for the reason,prevention and treatment of retention of double-J ureteral catheter

目的：分析双 J 管长期滞留原因，并探讨其预防与治疗的方法。方法8例双 J 管长期滞留患者，先采用体外振波碎石，将输尿管末端体外牵引，然后行输尿管镜下气压弹道碎石或钬激光碎石，再试行拔除双 J 管。结果经上述治疗后所有患者滞留的双 J 管均拔除，除2例患者术后存在肾内结石残余以外，所有患者均未发生输尿管断裂及输尿管狭窄等并发症。结论患者遗忘拔管或对双 J 管滞留所致后果的严重性估计不足，以及医师在诊疗过程中责任心不强是发生双 J 管长期滞留的主要原因；输尿管镜下碎石拔管术可治疗双 J 管滞留，其中采用钬激光高频低能碎石能减少结石残余。

Objective To analyze the reasons for long-term retention of double-J ureteral car-heter and explore its prevention and treatment.Methods The clinical data of eight patients with long-term retention of double-J ureteral catheter were retrospectively reviewed.Ureteroscopic lithotripsy was used to treat the patients and experience in prevention and treatment was discussed.Results After the a-bove treatment,the stranded double-J ureteral catheters of all patients were removed except for two patients who had residual renal calculi after the treatment;no patient had ureter rupture,ureter stenosis and other complications.Conclusion The main reasons for long-term retention of double-J ureteral catheter may be：The Patients forgot or underestimated the severity of the consequences caused by the stranded double-J ureteral catheter;and the physician pay little attention to it in the treatment process;the ureteroscopic lithotripsy can treat the double-J ureteral catheter retention,and holmium laser with high-frequency and low-energy can reduce the residual stones.