摘要
目的探讨一种免膀胱镜的简易拔管方法取出输尿管支架管(双J管)的可行性。方法回顾性分析2020年9月~2022年2月输尿管镜碎石术后留置单侧双J管179例的资料,患者选择拔管方式,简易组95例,用F_(10)胃管和0号聚丙烯滑线带出双J管,膀胱镜组84例,常规行膀胱镜双J管取出术。比较2组拔管成功率、拔管时间、治疗费用、术后不适症状(膀胱刺激和肉眼血尿)发生率。结果简易组男、女性拔管成功率分别为98.4%(60/61)和100%(34/34),膀胱镜组男、女性拔管成功率均为100%(55/55和29/29),2组差异无统计学意义(均P>0.05)。与膀胱镜组相比,简易组男、女性拔管时间更短[(4.1±0.9)min vs.(5.2±1.0)min,(3.1±0.8)min vs.(4.1±1.2)min,均P=0.000],治疗费用更少[(249.2±135.3)元vs.(1248.7±202.4)元,(233.3±32.4)元vs.(1200.4±178.7)元,均P=0.000],男性膀胱刺激症状和术后不适症状总发生率更低[9.8%(6/61)vs.27.3%(15/55),P=0.015;13.1%(8/61)vs.32.7%(18/55),P=0.011]。结论免膀胱镜简易方法行双J管取出简便、安全、有效,医疗费用低,术后并发症少,可以在临床中应用。
Objective To explore the feasibility of a novel non-cystoscopic simple procedure to remove ureteral stents.Methods Clinical data of 179 patients with unilateral double J tube indwelling after ureteroscopic lithotripsy from September 2020 to February 2022 were retrospectively analyzed.The method of extubation was selected by patients.The double J tube was removed with F_(10) gastric tube and No.0 polypropylene suture in 95 patients(simple group),while routinely removed with cystoscopy in 84 patients(cystoscopy group).The success rate of extubation,extubation time,treatment expenses and the incidence of postoperative discomfort(bladder irritation and gross hematuria)were compared between the two groups.Results The success rate of extubation in the simple group was 98.4%(60/61)and 100%(34/34)for men and women,respectively,and 100%(55/55)and 100%(29/29)in the cystoscopy group,respectively.There was no significant difference between the two groups(both P>0.05).Compared with the cystoscopy group,the extubation time for men and women in the simple group was shorter[(4.1±0.9)min vs.(5.2±1.0)min,(3.1±0.8)min vs.(4.1±1.2)min,both P=0.000],the treatment expenses for men and women was less[(249.2±135.3)yuan vs.(1248.7±202.4)yuan,(233.3±32.4)yuan vs.(1200.4±178.7)yuan,both P=0.000],and the incidence of bladder irritation and total postoperative discomfort for men was lower[9.8%(6/61)vs.27.3%(15/55),P=0.015;13.1%(8/61)vs.32.7%(18/55),P=0.011].Conclusion Using simple procedure without cystoscope to remove the ureteral stent is convenient,safe,effective,and cost efficient,with less postoperative complications,which is worthy of clinical application.
作者
韩孝洲
刘剑新
张勇
田长海
刘旺
胡华军
Han Xiaozhou;Liu Jianxin;Zhang Yong(Department of Urology,Shanghai TCM-integrated Hospital,Shanghai University of TCM,Shanghai 200082,China)
出处
《中国微创外科杂志》
CSCD
北大核心
2022年第9期728-732,共5页
Chinese Journal of Minimally Invasive Surgery
基金
上海市卫生健康委员会卫生行业临床研究专项(201940426)
上海市虹口区卫生健康委员会医学科研专项(虹卫2102-03)。
关键词
免膀胱镜
输尿管支架
Without systoscope
Ureteral stent
