不同材质双J管在人体留置后并发症的临床研究

Clinical Study on the Complications of Indwelling Different Double J Tubes in Human Body

目的：评价2种材质的双J管临床应用的效果,为经济、合理地选用不同材质的双J管提供依据,减少双J管留置后并发症的发生.方法：选择2014年5月-2015年5月某院及协作医院需留置双J管的患者60例并随机分为A、B二组.在手术结束前经输尿管镜逆行置入双J管.根据组别分别留置普通聚氨酯双J管（A组）和聚乙二醇水凝胶涂层双J管（B组）,留置28d后经膀胱镜拔除双J管.观察记录相关并发症的发生情况.结果：（1）聚乙二醇水凝胶涂层组（B组）尿沉渣白细胞情况好于普通聚氨酯组（A组）,另外随着天数增加,两组尿沉渣白细胞情况均变差;（2）普通聚氨酯双J管和聚乙二醇水凝胶覆盖的聚氨酯双J管在人体留置后均发生相关并发症,聚乙二醇水凝胶涂层组（B组）并发症情况明显好于普通聚氨酯组（A 组）,且随着双J管留置时间延长相关并发症均明显升高;（3）A、B两组双J管结垢分度情况分别为1度46.7%和66.7%、2度33.3%和23.3%、3度20.0%和10.0%,且聚乙二醇水凝胶涂层组（B组）双J管结垢情况明显好于普通聚氨酯组（A组）.结论：与普通聚氨酯双J管相比,聚乙二醇水凝胶覆盖的聚氨酯双J管有效的减少了术后感染的发生率,有效减少相关并发症的发生率以及减轻并发症的程度,能一定程度上减少双J管结垢情况的发生率,具有较好的临床应用价值,适于广泛应用于临床经输尿管镜钬激光碎石手术后.

Objective: To evaluate the clinical effect of 2 kinds of double J tube,and to provide the reference for the economic and rational use of the double J tube with different materials,and reduce the occurrence of complications after double J tube indwelling. Methods: 60 patients with double J tube in a hospital from May 2014 to May 2015 were randomly divided into two groups. Double J tube was inserted by the ureter mirror before the operation. The A group used ordinary PU double J tube and the B group usedpolyethylene glycol hydrogel coated double J tube. The tubes were removed 28 days later. Observe and record the occurrence of related complications. Results:( 1) The urine white blood cell state in B groupis better than that in A group,and urine white blood cell in two groups become poor as time passes;( 2) common polyurethane double J tube and polyethylene glycol hydrogel covered polyurethane double J tube both occured complications,B group was significantly better than A group,and with the double J tube indwelling time increasing,related complications significantly increased;( 3) The depositing situation of double J tube in two groups were 1 degree 46. 7% and 66. 7%,2 degree33. 3% and23. 3%,3 degree 20% and 10%,and B group was significantly better than A group. Conclusion: Compared with the common polyurethane double J tube,polyethylene glycol hydrogel covered polyurethane double J tube can effectively reduce the incidence of postoperative infection,reduce the incidence of complications and reduce the incidence of complications. It can be used to reduce the incidence rate of double J tube. It has good clinical application value,and is suitable for the clinical treatment of holmium laser lithotripsy in clinic.