同侧两根双J管在输尿管镜钬激光碎石术后的应用效果

目的探讨经输尿管镜钬激光碎石术后同侧放置两根双J管的应用效果。方法选取2013年1月至2014年12月期间采用输尿管镜钬激光碎石术治疗且符合病例纳入标准的患者128例，采用随机数字法将患者分为观察组及对照组，每组各64例。对照组患者术后留置单根双J管，观察组患者术后留置同侧两根双J管。对比两组患者中、重度肾积水发生率、结石清除率、视觉模拟评分（VAS）、肉眼血尿、膀胱刺激征等指标。结果两组治疗第15、60天结石清除差异无统计学意义（P〉0．05）。与对照组比较，观察组中、重度肾积水发生率明显较低，差异有统计学意义（P〈0．05）；肉眼血尿、膀胱刺激征、VAS评分差异无统计学意义（P均〉0．05）。结论输尿管结石尤其是输尿管狭窄发生风险较高的患者输尿管镜钬激光碎石术后留置同侧两根双J管可以明显降低中、重度肾积水的发生。

Objective To investigate the effect of ipsilateral two double J tubes after ureteroscopy holmium laser lithotripsy. Methods 128 patients with holmium laser lithotripsy treatment who enrolled in our hospital from Jan. 2013 to Dec. 2013 were randomly divided into experimental group and control group, 64 cases in each group. The single double J tube was used in the control group, ipsilateral two double J tube in the experimental group. The indexes including the incidence of severe hydronephrosis, stone clearance rate, Visual analogue scale （ Visual analog scale, VAS ） , blood urine, bladder irritation were compared. Results The stone clearance rates after 15-day treatment, 60-day treatment in the two groups were no different （ 89.1% vs 87.5%; 89.1% vs 98.4%; P〉0.05 ） . The incidence of moderate and severe hydronephrosis in the experimental group were significantly lower （ 4.7% vs 21.9%, P〈0.05 ） . The incidence of blood urine, bladder irritation and VAS score in the two groups were not significant difference （ P〉0.05 ） . Conclusions The incidence of moderate and severe hydronephrosis are lower after holmium laser lithotripsy in patients with ureteral calculi by indwelling ipsilateral two double J tube, especially those with higher risk of ureteral stricture.