摘要目的：探讨术后留置双J管对单侧中上盏肾结石输尿管软镜碎石术（FURL）后疗效及安全性。方法：回顾性分析2019年4月至2021年10月安徽省阜阳市第二人民医院泌尿外科接受FURL术单侧中上盏肾结石患者122例,根据术后是否留置双J管分为未置管组57例和置管组65例。比较两组患者结石清除率、手术时间、住院时间、并发症及腰腹疼痛发生情况。结果：全部患者均顺利完成手术,镜鞘置入顺利,未见输尿管或肾脏黏膜损伤。相比未置管组,置管组手术时间长[（52.05±12.17） vs. （48.87±10.84）min],术后血尿[55.38%（36/65） vs. 26.32%（15/57）]和膀胱刺激发生率[33.85%（22/65） vs. 12.28%（7/57）]、术后7d、14d和28d腰腹疼痛发生率[55.38% vs. 33.33%; 41.54% vs. 15.79%;36.92% vs. 3.51% ]高,差异具有统计学意义（P<0.05）。结论：对于基础身体机能状态较好、结石负荷较低的单侧中上盏肾结石患者,FURL术后不留置双J管更有助于缩短手术时间,降低术后血尿和膀胱刺激发生风险。
Abstract：Objective： To investigate the efficacy and safety of postoperative indwelling double-J stent for unilateral flexible ureteroscopic lithotripsy （FURL） for upper and middle caliceal renal calculi. Methods： From April 2019 to October 2021, 122 patients with unilateral middle-upper calyceal renal calculi who underwent FURL in the Department of Urology of the Second People's Hospital of Fuyang City, Anhui Province were retrospectively analyzed. Fifty-seven patients in the no catheterization group and 65 in the catheterization group were divided according to whether or not a double J stent was left in place after surger.The stone clearance rate, operation time, hospital stay, complications and incidence of lumbar and abdominal pain were compared between the two groups. Results： All patients successfully completed the operation, and the endoscopic sheath was placed smoothly. No ureter or kidney mucosa injury was found. In the catheterization group, operative time was longer [（52.0±12.17） vs. （48.87±10.84） min], the incidence of postoperative hematuria [55.38% （36/65） vs. 26.32% （15/57）], incidence of bladder irritation [33.85% （22/65） vs. 12.28% （7/57）], and incidence of lumbar and abdominal pain at 7st, 14th and 28th day after surgery [55.38% vs. 33.33%; 41.54% vs. 15.79%; 36.92% vs. 3.51%] were higher than in no catheterization group, and the difference was statistically significant （P<0.05）. Conclusion： Postoperative indwelling double-J stent is not helpful to shorten the operation time and reduce the risk of hematuria and bladder irritation after FURL for patients with unilateral middle-upper caliceal calculi with good basic physical function and low stone load.
范振永, 詹扬, 刘文健, 郭立刚, 梅国徽, 王二朋, 王海江, 戴廷山. 输尿管软镜碎石术后无管化的临床研究[J]. 微创泌尿外科杂志, 2022, 11(4): 235-238.
Fan Zhenyong, Zhan Yang, Liu Wenjian, Guo Ligang, Mei Guohui, Wang Erpeng, Wang Haijiang, Dai Tingshan. Clinical study of tubeless after soft ureteroscopic lithotripsy. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2022, 11(4): 235-238.
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