经输尿管镜碎石术后留置支架管与否的探讨

目的 探讨不复杂性输尿管结石经输尿管镜碎石术后是否需要常规留置支架管。方法 回顾性分析2002年3月-2005年3月我院450例不复杂性输尿管结石行输尿管镜钬激光碎石术患者的资料。患者被分为三组：A组196例（放置双J管），B组185例（放置临时输尿管导管），C组69例（不放置支架管）。手术时间、术后无石率和并发症作为评价的指标。结果 三组患者手术时间比较，A、B两组显著长于C组；术后患者血尿的发生率和持续时间，A、B两组显著高于C组；术后患者肋腹区疼痛、尿频／尿急、排尿困难、尿路感染和输尿管狭窄的发生率，三组之间无显著差异；术后1个月输尿管无石率三组均为100％。结论 经输尿管镜钬激光治疗不复杂性输尿管结石术后放置支架管与否应视术中情况。所有病例均常规留置支架管是不必要的。

Necessity of placement of ureteral stents after ureteroscopy for ureteral calculi

Objective To assess the necessity for routine ureteral stenting after ureteroscopic intracorporeal lithotripsy. Methods Data 450 patients who underwent uncomplicated ureteroscopic intracorporeal lithotripsy by the holmium laser in our hospital were analysed retrospectively. The patients divided into three groups(group A, 196 patients with double pigtail stent indwelled and group B,185 patients with ureteral catheter indwelled and group C, 69 patients without stent). The mean operative time, postoperative complications and the stone-free rate were measured. Results Mean operative time of the stented group( A and B) was significantly longer than that of the unstented group. Hematuria was more severe and prolonged in group A and B(P< 0.01). The incidence of flank /abdominal pain,dysuria, frequency/urgency, urinary infection and anatomical ureteral narrowing were not statistically different among the three groups. The stone-free rate was 100% in each group. Conclusion Routine placement of ureteral stents is unnecessary after uncomplicated ureteroscopy for ureteral calculi. Whether the clinician should indwell ureteral stents or not depends on the operation situation.