腔内两根双J管治疗单根双J管无效的良性输尿管狭窄疗效观察

Treatment of ureteral stricture by simultaneous placement of two ipsilateral ureteral stents

目的 探讨对于良性输尿管狭窄的患者,放置单根双J管无效后,改用同侧输尿管腔内放置两根双J管引流的安全性和有效性.方法 对本院2012年1月至2016年4月收治11例良性输尿管狭窄的患者,留置单根双J管无效后,输尿管腔内置入两根4.7F双J管引流,3个月后拔除,拔管后1个月B超或CT测定患者的肾积水的变化.结果 11例患者随访3-12个月,平均6个月.患者都能耐受两根双J管,无明显的腰腹胀痛、发热、肉眼血尿等症状.术后3个月拔管前查腹部平片示双J管无移位,拔管后1个月B超或CT示患者肾积水不同程度减轻或消失.结论 对于良性输尿管狭窄的患者,放置单根双J管无效后,改用同侧输尿管腔内留置两根双J管引流安全有效,但远期效果和机制需要大样本进一步研究验证.

Objectives To evaluate the safety and efficacy in the treatment of benign ureteral stricture by placing two ipsilateral ureteral stents simultaneously.Methods Between 2012 and 2016, seven male and four female patients who had benign ureteral stricture underwent single stent treatment to relieve obstruction.After failure of such management, two 4.7 F double-J ureteral stents were placed.Kidney, ureter and bladder X-ray was conducted to identify the location of double-J ureteral stents three months after the operation.B-mode ultrasound or CT was used to determine the clinical efficacy one month after stent removal.Results Insertion of two 4.7 F double-J ureteral stents in a single ureter was successful in all cases.During the mean follow-up of 6 months （range 3-12 months）, no flank abdomen pain,fever,hematuria,displacement of double-J catheters occurred in all patients.The hydronephrosis was markedly improved in patients.Conclusions Simultaneous placement of two double J ureteral stents for the treatment of benign ureteral stricture is safe and effective.Long-term efficacy and the exact mechanism need further investigations.