Abstract:objective: To compare the effect of ureteral catheter indwelling or double J catheter indwelling through cystoscope before percutaneous nephrolithotomy on the safety and effectiveness of percutaneous nephrolithotomy. Methods: The clinical data of 157 patients underwent PCNL from January 2017 to December 2017 were retrospectively analyzed. Among them, 89 cases were retrograde indwelling F5 ureteral catheter (group A) and 68 cases were retrograde indwelling F4.7 double J catheter (group B). The differences in the parameters such as channel establishment time, operation time, renal hemorrhage(or not), stone clearance rate, postoperative renal function changes, and postoperative hemoglobin changes were compared between the two groups. Results: There was no significant differences between the two groups in the time of establishing the channel, the time of operation, the condition of renal hemorrhage, the rate of stone clearance, the changes of renal function and hemoglobin after operation (P>0.05). Conclusion: Indwelling F5 ureteral catheter and indwelling double J tube for artificial hydronephrosis have no significant effect on the safety and efficacy of percutaneous nephrolithotomy, the differences is not statistically significant. The preoperative indwelling of double J tube can shorten the operation time, give the surgeon more choices on the puncture path, reduce the risk of infection, and improve the success rate of double J tube indwelling. Therefore, it can be advocated that double J catheter should be placed before operation instead of indwelling ureteral catheter.
刘跃闻, 李建中, 周亚军, 李昕. 逆行留置输尿管导管与留置双J管对经皮肾镜碎石术的安全有效性的对比研究及临床体会[J]. 微创泌尿外科杂志, 2019, 8(1): 25-28.
LIU Yuewen, LI Jianzhong, ZHOU Yajun, LI Xin. Comparative study and clinical experience of retrograde indwelling ureteral catheter and indwelling double J tube for percutaneous nephrolithotomy. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2019, 8(1): 25-28.
[1] CRACCO CM, SCOFFONE CM, SCARPA RM.New developments in percutaneous techniques for simple and complex branched renal stones. Curr Opin Urol, 2011,21(2):154-160. [2] GHANI KR, SAMMON JD, BHOJANI N, et al.Trends in percutaneous nephrolithotomy use and outcomes in the United States. J Urol, 2013,190(2):558-564. [3] 刘成倍,徐伟,廖春华.微创经皮肾镜取石术治疗上尿路结石合并感染的临床研究.中华医院感染学杂志,2014,24(1):162-164. [4] 周铁,陈光华,高小峰, 等.下盏入路经皮肾镜双J管放置困难原因和技术改进.微创泌尿外科杂志,2013,2(2):119-120. [5] 钟文,曾国华,杨后猛,等.微创经皮肾镜取石术中肾盂内压变化对术后发热的影响.中华泌尿外科杂志,2008,29(10):668-671. [6] TURNA B, NAZLI O, DEMIRYOGURAN S, et al.Percutaneous nephrolithotomy: variables that influence hemorrhage. Urology, 2007,69(4):603-607. [7] 韦巍,钟羽翔,黄剑华,等.经皮肾镜碎石术后双J管相关严重并发症危险因素的Logistics回归分析.南方医科大学学报,2016,36(10):1440-1443. [8] MAHESHWARI PN, MANE DA, PATHAK AB.Management of pleural injury after percutaneous renal surgery. J Endourol,2009,23(10):1769-1772. [9] 黄韬,吕磊,王勇军,等.超声引导下经皮肾镜取石术中肾盂内压变化与术后发热的关系.临床泌尿外科杂志,2013,27(4):292-294. [10] 叶俊杰,杨宇,张会江,等.超声引导经皮肾镜取石术中不行人工肾积水的随机对照研究.中华外科杂志,2018,56(5):386-390. [11] 刘崇刚. 经皮肾镜碎石取石术后尿源性脓毒血症休克的防治.中国继续医学教育,2017,9(3):80-81. [12] 白福鼎,吴慧锋,文甲明,等.预先留置双J管在经皮肾镜取石术中应用的临床分析.中华医学杂志,2018,98(6):454-456.