同侧两根双J管引流在结石伴息肉导致输尿管狭窄患者中的应用

Treatment of ureterostenosis secondary to ureteral calculi with two ipsilateral double J stents

目的观察同侧两根双J管引流在结石伴息肉导致输尿管狭窄患者中的应用效果。方法选取2012年1月至2017年6月期间我院收治的输尿管结石伴息肉导致输尿管狭窄患者80例,采用随机数字法将患者分为研究组及对照组,每组各40例。研究组患者腔内碎石术后同侧输尿管内留置两根双J管,对照组患者腔内碎石术后留置单根双J管。根据术中情况,双J管留置4~12周,平均8周。拔管后4周复查血肌酐和泌尿系超声,了解输尿管结石残留情况和肾积水程度,比较两组患者血肌酐、结石清除率和肾积水的变化。结果拔管后4周,两组患者血肌酐下降和结石清除率差异均无统计学意义(P>0.05)。研究组和对照组手术后肾积水均有明显的改善,肾积水下降值分别为(23.5±7.0)mm vs(20.1±7.3)mm差异有统计学意义(P<0.05)。结论输尿管结石伴息肉导致输尿管狭窄的患者,输尿管腔内碎石术后同侧留置两根双J管短期引流效果优于留置单根双J管,但远期效果和机制需要大样本进一步研究验证。

Objective To evaluate the clinical efficacy of intracavitary drainage using two ipsilateral double pigtail stents in the treatment of ureteral stricture secondary to ureteral calculi.Methods Eighty patients with ureteral stricture secondary to ureteral calculi who enrolled in our hospital from January 2012 to June 2017 were randomly divided into study group and control group,40 cases in each group.The single double pigtail stent was used in the control group,while ipsilateral two double pigtail stents in the study group.Postoperatively double pigtail stents were placed in ureters for 4 to 12 weeks with a median of 8 weeks.The indexes including serum creatinine,stone clearance rate and hydronephrosis were compared.Results The decrease of serum creatinine and stone clearance rates 4 weeks after stents removal in the two groups had no statistical difference(P>0.05).However,the hydronephrosis in the study group was improved better than that in the control group[(23.5±7.0)mm vs(20.1±7.3)mm,P<0.05)].ConclusionsPlacement of two indwelling double pigtail stents appears to achieve a better drainage compared with single pigtail stent for the management of ureteral stricture secondary to ureteral calculi,long-term efficacy and the exact mechanism need further investigations.