| 双重双J管置入联合N-trap网篮对嵌顿性输尿管结石钬激光碎石术后狭窄的预防作用 |
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| 引用本文： | 孙阳,刘莹,巫嘉文,宋小飞.双重双J管置入联合N-trap网篮对嵌顿性输尿管结石钬激光碎石术后狭窄的预防作用[J].蚌埠医学院学报,2022,47(9):1241-1245. |
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| 作者姓名： | 孙阳 刘莹 巫嘉文 宋小飞 |
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| 作者单位： | 1.复旦大学附属闵行医院 泌尿外科, 上海 2011992.复旦大学附属闵行医院 超声科, 上海 201199 |
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| 摘 要： | 目的探讨输尿管镜钬激光碎石术后置入2根双J管联合术中N-trap网篮对术后输尿管狭窄的预防效果。方法回顾性分析因嵌顿性结石行输尿管镜钬激光碎石术后留置单根F7双J管或2根F6双J管病人临床资料，按倾向性评分法，以结石长径及嵌顿时间匹配入组97对(n=194)，比较2组病人术后狭窄发生率(置管8~10周，随访终点时间1年)、净石率及双J管相关尿路症状发生率。结果术后首日复查病人总体净石率达到88.1%(171/194)，2组净石率差异无统计学意义(P>0.05)；拔除双J管后随访过程中共发现输尿管狭窄22例，总发生率为11.3%，其中单根F7双J管组输尿管狭窄发生率明显高于2根F6双J管组(P < 0.01)，留置2根F6双J管是输尿管镜碎石术后输尿管狭窄发生的保护因素(RR=0.294，95%CI 0.113~0.766)；2组双J管相关尿路症状(发生肉眼血尿、尿急、尿频、下腹痛、腰痛中至少一项)发生率均接近100%，差异无统计学意义(P>0.05)。结论嵌顿性输尿管结石行输尿管镜钬激光碎石术后置入2根双J管配合术中N-trap网篮的使用能更为安全、可靠地降低术后输尿管狭窄的发生风险。
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| 关 键 词： | 输尿管结石 钬激光碎石术 输尿管狭窄 双重双J管置入 N-trap网篮 |
| 收稿时间： | 2021-11-02 |
Protective effect of two double-J stents placement combined with N-trap stone basket agains postoperative ureteral stricture after ureteroscopic Ho: YAG lithotripsy |
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| Affiliation: | 1.Department of Urology, Minhang Hospital Affiliated to Fudan University, Shanghai 201199, China2.Department of Ultrasound, Minhang Hospital Affiliated to Fudan University, Shanghai 201199, China |
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| Abstract: | ObjectiveTo investigate the protective effect of two double-J stents placement combined with N-trap stone basket against postoperative ureteral stricture after ureteroscopic Ho: YAG lithotripsy.MethodsInformation of patients with impacted ureteral stones who underwent single F7 or two F6 double-J stents placement during ureteroscopic Ho: YAG lithotripsy was retrospectively reviewed.A total of 97 pairs of patients (n=194) were distributed into two groups (single-F7 stents group and two-F6 stents group) by means of propensity score matching with stone size and impaction period being predictors.Postoperative ureteral stricture rate (with stents in place for 8 to 10 weeks and 1 year follow-up), stone-free rate and stent-related urinary symptom incidence were compared between two groups.ResultsOn the first day after operation, the overall stone free rate of patients reached 88.1% (171/194), and there was no significant difference between the two groups (P>0.05).During follow-up after stent removal, 22 cases of ureteral stricture (overall incidence 11.3%) were diagnosed.The incidence of ureteral stenosis in the single-F7 stents group was significantly higher than that in the two-F6 stents group (P < 0.01).Indwelling two F6 double-J stents was a protective factor for ureteral stricture after ureteroscopic lithotripsy (RR=0.294, 95%CI: 0.113-0.766).Incidence of stent-related urinary symptoms (at least one of gross hematuria, urgency, frequent urination, lower abdominal pain, flank pain) reached almost 100% in both groups, and showed no significant difference(P>0.05).ConclusionsAfter ureteroscopic Ho: YAG lithotripsy for incarcerated ureteral calculi, the placement of two double-J stents combined with N-trap stone basket can safely and reliably reduce the risk of postoperative ureteral stricture. |
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