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微创泌尿外科杂志  2018, Vol. 7 Issue (6): 401-405    DOI: 10.19558/j.cnki.10-1020/r.2018.06.010
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改良双J管留置法预防带管相关性下尿路症状的临床疗效观察
郭凯1,2, 王永传2, 都靖2, 周海军2, 任安吉2, 王凯2, 伦晓璐2, 王晓龙2, 邵怡3
1潍坊医学院外科学教研室 261053 山东潍坊;
2潍坊市中医院泌尿外二科;
3上海交通大学附属第一人民医院泌尿外科
Clinical efficacy of modified ureteral stent for the related lower urinary tract symptoms caused by ureteral double J stent indwelling
Guo Kai1,2, Wang Yongchuan2, Du Jing2, Zhou Haijun2, Ren Anji2, Wang Kai2, Lun Xiaolu2, Wang Xiaolong2, Shao Yi3
1Department of Surgery, Weifang Medical University, Shandong 261053, China;
2Weifang Traditional Chinese Medicine Hospital;
3Shanghai Jiaotong University Affiliated First People's Hospital
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摘要 目的 探讨改良双J管留置法在预防带管相关性LUTS中的作用。方法 选取2015年11月~2017年11月在潍坊市中医院接受经尿道输尿管软镜钬激光碎石术(fURL)的肾和输尿管中上段结石患者58例,随机分为两组:观察组采用改良双J管留置法,即根据输尿管长度将双J管末端进行不同程度地部分剪除(计划2周内拔管者,裁剪后的双J管末端缝3-0可吸收线打结),然后经尿道将双J管完全推入输尿管腔,双J管下端位于输尿管壁内段上方1~3 cm处;对照组术后采取常规双J管留置法。术后2~4周拔出双J管,对于严重输尿管狭窄者拔管时间延长至3~6个月。所有患者双J管留置术前和拔管前完成输尿管相关症状问卷(USSQ)及IPSS评分,对患者下尿路症状、疼痛评分、血尿评分和整体健康状况进行评估。结果 两组患者在双J管置入术前各项观察指标比较,差异无统计学意义(P>0.05)。两组患者在双J管拔除前USSQ的泌尿系症状评分分别为(25.4±5.5)与(29.2±5.7)分、疼痛总评分为(7.8±1.8)与(15.7±2.8)分、血尿评分(1.5±0.5)与(2.6±0.9)分、平均健康状况评分为(11.3±4.1)与(13.4±3.4)分、IPSS为(9.7±2.2)与(13.7±1.6)分,组间比较均差异有统计学意义(P<0.05)。结论 改良双J管留置法可明显改善fURL术后因双J管留置引起的LUTS等不适症状,特别是对于那些因输尿管中上段狭窄需要长期留置双J管且对带管刺激症状较为敏感的患者,效果更佳。
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作者相关文章
郭凯
王永传
都靖
周海军
任安吉
王凯
伦晓璐
王晓龙
邵怡
关键词 双J管下尿路刺激症状输尿管软镜碎石术    
AbstractObjective: To observe the preventive effect of the modified ureteral stent indwelling for the double-J stent related lower urinary tract symptoms (LUTS) and other discomforts. Methods: Fifty-eight cases of upper urinary tract calculi treated by flexible ureteroscopic lithotripsy (fURL) were randomly divided into two groups: the observation group treated with the modified ureteral stent (the distal circle end was cut in different length according to the length of patients' ureter, the lower part of ureteral stent was completely pushed into the ureteral lumen above the intramural part (usually 1-3 cm), and the end of ureteral stent was fixed with 3-0 absorbable suture for those patients whose ureteral stent was planned to be removed in two weeks after fURL; the control group was treated with the routine ureteral stent indwelling method. The ureteral stents usually were removed in 2-4 weeks after fURL, while the ureteral stent indwelling time was prolonged to 3 or 6 months for those patients with proximal or middle ureteral stenosis. All the patients were asked to complete the ureteral stent symptoms questionnaire (USSQ) and international prostate symptom score (IPSS) before fURL and 2-4 weeks after the operation. The LUTS, physical pain and the general condition scores were evaluated. Results: There was no significant difference between the two groups before fURL (P>0.05). Before the removal of the ureteral double J stent indwelling, the USSQ scores in the control group and observation group were (25.4±5.5) vs. (29.2±5.7); the physical pain symptom scores were (7.8±1.8) vs. (15.7±2.8); the hematuria scores were (1.5±0.5) vs. (2.6±0.9); the general condition scores were (11.3±4.1) vs. (13.4±3.4); the IPSS scores were (9.7±2.2) vs. (13.7±1.6), respectively. All the differences above between the two groups were statistically significant (P<0.05). Conclusions: The modified ureteral stent indwelling method can significantly improve the related LUTS and other discomforts caused by routine ureteral double-J stent indwelling.
Key wordsdouble-j stent    lower urinary tract symptom    flexible ureteroscopic lithotripsy
收稿日期: 2018-07-02     
ZTFLH:  R691.4  
基金资助:山东省潍坊市科技计划项目(wfwsjs_2018_111)
通讯作者: 王永传chinawyc@hotmail.com   
引用本文:   
郭凯, 王永传, 都靖, 周海军, 任安吉, 王凯, 伦晓璐, 王晓龙, 邵怡. 改良双J管留置法预防带管相关性下尿路症状的临床疗效观察[J]. 微创泌尿外科杂志, 2018, 7(6): 401-405.
Guo Kai, Wang Yongchuan, Du Jing, Zhou Haijun, Ren Anji, Wang Kai, Lun Xiaolu, Wang Xiaolong, Shao Yi. Clinical efficacy of modified ureteral stent for the related lower urinary tract symptoms caused by ureteral double J stent indwelling. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2018, 7(6): 401-405.
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