双J管结壳与留置时间及原发病的关系

The Relationship Between Indwelling Period,Primary Disease and Incidence of Double-J Ureteral Stent Calculus

目的:观察双J管结壳的形成,探究结壳与留置时间及原发病的关系,为双J管的留置时间通提供参考。方法:前瞻性选取40例在输尿管内放置双J管的泌尿系手术患者,随机分为结石组和非结石组,每组各20例。结石组患者术前有尿路结石,非结石组患者术前无尿路结石。各组双J管留置时间均为75天。术后第15、30、45、60天,通过膀胱镜检、腹部平片检查(除外已发现双J管结壳者)或肉眼检查双J管(第75天),记录双J管结壳的形成。结果:至术后第75天,结石组有5例退出,非结石组有4例退出。术后第15天,结石组和非结石组双J管结壳率分别为6.67%和6.25%;术后第30天,结石组和非结石组双J管结壳率分别为20.00%和12.05%;术后第45天,结石组和非结石组双J管结壳率分别为26.67%和18.75%;术后第60天,结石组和非结石组双J管结壳率分别为47.67%和31.25%;术后第75天,结石组和非结石组双J管结壳率分别为60.00%和43.75%。术后第30天以后,结石组双J管结壳率比非结石组显著升高。结石组和非结石组双J管的结壳率与其留置时间呈正相关。结论:双J管的结壳率与其留置时间呈正相关。对于术前有尿路结石的患者,置管第30天以后其双J管结壳率明显高于术前无尿路结石的患者。

Objective To observe prospectively the formation of double-J ureteral stent calcules and investigate the relationship between indwelling period of double-J ureteral stent,primary deceases and incidence of double-J ureteral stent calculus,thereby providing a reference for the appropriate indwelling period of double-J ureteral stent. Methods Forty patients undergoing urinary operation were indwelled double-J ureteral stents,and randomly divided into stone group( n = 20) and non-stone group( n = 20). The patients in stone group had diagnosis of urinary stones,while the patients in non-stone group had no diagnosis of urinary stones. Cystoscopy and abdominal Xray examinations were procedured to determine the formation of double-J ureteral stent calculus on postoperative day15,30,45,60 respectvely( the patients having been determined of double-J ureteral stent calculus were exclusive),and the calculus of double-J ureteral stent were macroscopically tested on postoperative day 75. Results There were 5 patients in stone group and 4 patients in non-stone group that withdrawed from the study. Incidences of double-J ureteral stent calculus were 6. 67% and 6. 25% in stone group and non-stone group respectively on postoperative day 15. Incidences of double-J ureteral stent calculus were 20. 00 and 12. 05% in stone group and non-stone group respectively on postoperative day 30. Incidences of double-J ureteral stent calculus were 26. 67%and 18. 75% in stone group and non-stone group respectively on postoperative day 45. Incidences of double-J ureteral stent calculus were 47. 67% and 31. 25% in stone group and non-stone group respectively on postoperative day 60; Incidences of double-J ureteral stent calculus were 60% and 43. 75% in stone group and non-stone group respectively on postoperative day 75. The incidences of double-J ureteral stent calculus in both stone group and non-stone group were positively correlated with the indwelling period( r = 0. 75 and r = 0. 71 respectively; P <0. 05). The incidence of double-J ureteral stent calculus in stone group was significantly higher than that of nonstone group( P < 0. 05) since postoperative day 30. Conclusion The incidence of double-J ureteral stent calculus are positively correlated with the indwelling period of ureteral stent. After postoperative day 30,the incidence of double-J ureteral stent calculus in patients with preoperative diagnosis of urinary stone,is significantly higher than that in patients without preoperative diagnosis of urinary stones.