双J管留置时间对输尿管软镜碎石术后并发石街的影响

Clinical value of different double-J stent indwelling time in the treatment of ureteral stone-street complications after flexible ureteroscope lithotripsy

目的分析肾结石患者不同双J管留置时间在输尿管软镜碎石术后并发输尿管石街的治疗效果。方法选择2012-02-2015-02间64例实施输尿管软镜钬激光碎石术后并发输尿管石街的肾结石患者,依据不同双J管留置时间分为术后2周拔除双J管组（观察组）及带双J管排石组（对照组）,每组各32例,对比分析两组患者术后的排石成功率、医疗费用及并发症发生情况。结果观察组均成功排出结石,较对照组的排石成功率明显增高,排净结石时间较对照组明显缩短,医疗费用较对照组降低,膀胱刺激征及肉眼血尿的发生率明显低于对照组,差异均有统计学意义（P〈0.05）;而两组肾绞痛发生率差异无统计学意义。结论针对肾结石患者在输尿管软镜碎石术后2周再拔除双J管的方案,较带双J管排石的方案对术后并发输尿管石街排石的成功率要增高,还能减少尿路刺激症状及肉眼血尿的术后并发症,且医疗费用也降低。

Objective To investigate the clinical value of shortening doudle- J stent indwelling time in the treatment of ureteral stone- street complications after flexible ureteroscope lithotripsy. Methods Clinical data of 64 cases of ureteral stone- street complications after flexible ureteroscope lithotripsy from February 2012 to February 2015 were retrospectively analyzed. The patients were divided into group A（ extubating the double- J stent two weeks after the surgery） and group B（ retaining the doubele- J stent） with 32 cases in each group. The stone clearance results were compared. Results All the urinary calculus in group A had been removed successfully,including 3 cases of irritative symptoms of bladder and 5 cases of gross hematuria. Hospital cost was（ 768. 4 ± 152. 6） yuan. Urinary calculus were successfully removed in 21 cases in group B,including 32 cases of gross hematuria and 29 cases of irritative symptoms of bladder. No renal colic occurred. Hospital cost was（ 1262. 3 ± 156. 8） yuan. Compared with group B,group A had higher success rate of stone clearance,lower hospital cost and lower rate of bladder irritative symptoms and gross hematuria（ P〈0. 05）. There were no significant differences between the two groups in the occurrence rate of renal colic. Conclusion Removing the double- J stent 2 weeks after flexible ureteroscope lithotripsy resulted in higher stone clearance rate and less complication compared with retaining the double- J stent. It can reduce the occurrence of irritative symptoms bladder and gross hematuria.