论文部分内容阅读
目的探讨双J管在输尿管镜下钬激光碎石术中应用的适应证及并发症的防治。方法对57例行输尿管镜下钬激光碎石术后留置双J管的患者的临床资料进行系统分析并结合文献复习。结果 57例患者中肉芽包裹性结石6例,碎石并切除肉芽后留置双J管;结石下方存在不同程度的输尿管扭曲狭窄,碎石后在扩张狭窄处后留置双J管44例;钬激光碎石时部分较大结石上移至肾盂7例,留置双J管后行体外冲击波碎石术治疗;复查腹部X线平片示结石均完全排出。留置双J管后出现膀胱刺激症状21例(36.8%),肉眼血尿11例(19.3%),腰部隐痛不适症状13例(22.8%),予对症治疗后症状均缓解。结论输尿管镜下钬激光碎石术后根据需要可留置双J管,双J管具有内支架及内引流的作用,置入和取出简单,安全可靠,并发症较轻,效果显著。
Objective To investigate the indications and complications of dual J tube in ureteroscopic holmium laser lithotripsy. Methods The clinical data of 57 patients undergoing ureteroscopic holmium laser lithotripsy with double J tube were systematically analyzed and reviewed. Results 57 cases of granulation-wrapped stones in 6 cases, gravel and excision of granulation after leaving double J tube; there are varying degrees of ureteral calculi under the stone stenosis, grafts in the dilatation and stenosis after leaving double J tube 44 cases; holmium laser Gravel when part of the larger stones on the renal pelvis moved to 7 cases, left double J tube after extracorporeal shock wave lithotripsy; review of abdominal X-ray showed stones are completely discharged. There were 21 cases (36.8%) of bladder irritation, 11 cases of gross hematuria (19.3%) and 13 cases (22.8%) of lumbar pain and discomfort symptom after symptomatic treatment. Conclusions Ureteroscopic holmium laser lithotripsy can be placed double J tube according to need. The double J tube has the function of internal stent and internal drainage. The insertion and removal are simple, safe and reliable with less complications and obvious effect.