缩短双J管留置时间对输尿管软镜碎石术后并发输尿管石街治疗的临床价值

目的：探讨缩短双J管留置时间对输尿管软镜碎石术后并发输尿管石街治疗的临床价值。方法回顾性分析我院2012年1月～2013年10月因肾结石行输尿管软镜钬激光碎石术后并发输尿管石街的患者38例，按拔除双J管时机不同，分为术后2周拔除双J管排石组（拔管排石组）及带管排石组各19例，比较两组排石效果。结果拔管排石组19例均成功排石，并发肾绞痛2例、膀胱刺激征3例、肉眼血尿3例，医疗费用（766．5±153．7）元；带管排石组成功排石13例，无肾绞痛，膀胱刺激征17例，肉眼血尿19例，医疗费用（1251．2±155．6）元。拔管排石组排石成功率高于带管排石组（P＜0．05），膀胱刺激征及肉眼血尿发生率、总医疗费用低（P＜0．05），2组肾绞痛发生率差异无显著性。结论对于输尿管软镜钬激光碎石术后并发输尿管石街的治疗，术后2周拔除双J管方案较带管排石方案成功率高，并发症发生率低，能减少尿路刺激症状和肉眼血尿的发生。

Clinical Value of Shortening Double-J Stent Indwelling Time in the Treatment of Ureteral Stone-street Complications after Flexible Ureteroscope Lithotripsy

Objective To investigate the clinical value of shortening double-J stent indwelling time in the treatment of ureteral stone-street complications after flexible ureteroscope lithotripsy . Methods Clinical data of 38 cases of ureteral stone-street complications following flexible ureteroscope lithotripsy from January 2012 to December 2013 in our hospital were retrospectively analyzed.The patients were divided into Group A （extubating the double-J stent two weeks after the surgery ） and Group B （retaining the double-J stent） with 19 cases in each group .The stone clearance results were compared . Results All the urinary calculus in Group A had been removed successfully , including 2 cases of renal colic , 3 cases of irritative symptoms of bladder and 3 cases of gross hematuria.Hospital cost was （766.5 ±153.7） yuan.Urinary calculus were successfully removed in 13 cases in Group B, including 19 cases of gross hematuria and 17 cases of irritative symptoms of bladder.No renal colic occurred.The hospital cost was （1251.2 ± 155.6） yuan.Compared with Group B , Group A has higher success rate of stone clearance , lower hospital cost and lower rate of bladder irritative symptoms and gross hematuria （P〈0.05）.There were no significant differences between the two groups in the occurrence rate of renal colic （P〉0.05）. Conclusions Removing the double-J stent 2 weeks after flexible ureteroscope lithotripsy resulted in higher stone clearance rate and less complications compared with retaining the double -J stent.It can reduce the occurrence of irritative symptoms bladder and gross hematuria .