双J管留置术后患者不耐受的原因分析

Analysis of the Causes of Intolerance in Patients After Double-J Ureteral Stents Indwelling

目的探究双J管留置术后患者出现双J管不耐受的原因及预防对策。方法回顾我院2017年6月-2019年6月因尿石症行输尿管镜、输尿管软镜或经皮肾镜碎石后留置双J管的患者,对双J管相关症状原因进行单因素及多因素统计分析。结果纳入234例患者,术后腰痛发生率35.9%,肉眼血尿发生率25.6%,膀胱刺激征发生率17.9%。单因素及多因素分析发现,影响患者术后腰痛症状因素包括双J管圆环状态及双J管朝向,影响患者术后血尿症状因素包括双J管圆环状态及双J管朝向,影响患者术后膀胱刺激症状因素为双J管长度。结论双J管圆环状态和双J管朝向是影响患者留置双J管术后腰痛及血尿的主要因素,双J管过长是影响患者术后膀胱刺激征的主要因素。通过适当的手法改良可以术中纠正双J管的圆环状态及朝向,可能有助于缓解患者术后双J管相关症状。

Objective To investigate the causes and preventive measures of double-J ureteral stents intolerance in patients after double-J ureteral stents indwelling. Methods The patients who have had double-J ureteral stents indwelling after ureteroscopic lithotripsy, flexible ureteroscopic lithotripsy or percutaneous nephrolithotripsy due to urolithiasis were reviewed between June 2017 and June 2019. Univariate and multivariate statistics were used to analyze the causes of double-J ureteral stents related symptoms. Results Of the 234 patients, the incidence of postoperative flank pain, gross hematuria, and bladder irritation were 35.9%, 25.6%, and 17.9%, respectively. Univariate and multivariate analysis found that the factors affecting postoperative flank pain include double-J ureteral stents ring status and double-J ureteral stents orientation, factors affecting postoperative hematuria include double-J ureteral stents ring status and double-J ureteral stents orientation, and factors affecting patient’s postoperative bladder irritation symptoms were length of double-J ureteral stents. Conclusion For patients after double-J ureteral stents indwelling, double-J ureteral stents ring status and orientation are the main factors affecting postoperative flank pain and hematuria, and length of double-J ureteral stents is the main factor affecting postoperative bladder irritation. Correcting the ring state and orientation of the double-J ureteral stents by appropriate manipulation can help relieve the patients’ tolerance to double-J ureteral stents after operation.