输尿管镜治疗复杂性输尿管结石术后留置双J管最佳时间临床分析

Clinical Analysis of Optimal Time for Indwelling Double J Tube after the Ureteroscopy for Complicated Ureteral Calculi

目的探讨术后留置双J管时间不同对复杂性输尿管结石患者经输尿管镜治疗后临床症状的影响,以确定术后留置双J管最佳时间。方法本研究选取于2016年7月至2018年7月医院收治的168例经输尿管镜治疗后的复杂性输尿管结石患者作为研究对象,根据术后留置双J管时间不同分为A组(<2 w) 56例、B组(2～6 w) 56例、C组(> 6 w)56例。比较3组患者置管后的相关并发症发生率、排石成功率、结石排净时间、医疗费用。结果 A组与B组患者置管后的相关并发症发生率比较无显著统计学意义(P> 0.05),但与C组比较,A组、B组患者置管后的相关并发症发生率均更低(P <0.05)。A组、B组置管后的排石成功率、结石排净时间、医疗费用比较无显著统计学意义(P> 0.05),而A组、B组分别与C组患者置管后的排石成功率、结石排净时间、医疗费用比较均具显著统计学意义(P <0.05)。结论复杂性输尿管结石患者经输尿管镜治疗后术后置管的相关并发症发生率随置管时间延长而升高,分析后认为术后2 w内留置双J管为最佳时间。

Objective To investigate the effect of different time of indwelling double J tube on the clinical symptoms of patients with complicated ureteral calculi after the ureteroscopy to determine the optimal time for postoperative indwelling double J tube.Methods In this study,168 patients with complicated ureterolithiasis treated with ureteroscopy were selected from July 2016 to July 2018.According to the different time of the double J tube after surgery,the patients were divided into group A(<2 w) with 56 cases,group B(2~6 w) with 56 cases and group C(〉6 w) with 56 cases.Incidence rate,stone removal success rate,stone clearing time and medical expenses of the three groups were compared.Results The incidence of related complications after tube placement was not statistically significant between group A and group B(P>0.05).But compared with group C,the incidence of related complications after tube placement in groups A and B was lower(P<0.05).There was no significant statistical significance between Group A and group B in the success rate of stone removal,stone clearing time and medical expenses after tube placement(P>0.05),but significantly different from those in group C(P<0.05).Conclusion The incidence of complications associated with ureteroscopic treatment of complicated ureterolithiasis increases with the time of catheter placement.After analysis,it is believed that the optimal time to retain double J tube is within 2 weeks after the operation.