[1]赵永录** 张兴盛 宋广智 张斌 顾鹏守 刘国淦 陈路晓.多根双J管置入在输尿管狭窄腔内钬激光切开中的应用体会[J].中国微创外科杂志,2022,01(6):467-471.
　Zhao Yonglu,Zhang Xingsheng,Song Guangzhi,et al.Clinical Experience of Multiple DoubleJ Tubes Placement in Intraluminal Holmium Laser Incision of Ureteral Stricture[J].Chinese Journal of Minimally Invasive Surgery,2022,01(6):467-471.
点击复制

多根双J管置入在输尿管狭窄腔内钬激光切开中的应用体会()
分享到：

《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2022年6期
页码:
467-471
栏目:
临床研究
出版日期:
2022-10-11

文章信息/Info

Title:
Clinical Experience of Multiple DoubleJ Tubes Placement in Intraluminal Holmium Laser Incision of Ureteral Stricture
作者:
赵永录** 张兴盛 宋广智 张斌 顾鹏守 刘国淦 陈路晓
(甘肃省武威市人民医院泌尿外科，武威733000)
Author(s):
Zhao Yonglu;  Zhang Xingsheng;  Song Guangzhi;  et al.
Department of Urology, People’s Hospital of Wuwei, Wuwei 733000, China
关键词:
多根双J管置入; 良性输尿管狭窄; 钬激光腔内切开
Keywords:
Multiple doubleJ tubes placement; Benign ureteral stricture; Holmium laser intraluminal incision
文献标志码:
A
摘要:
目的探讨输尿管狭窄腔内钬激光切开后多根双J管置入的应用价值。方法2017年1月~2020年12月，61例良性输尿管狭窄行腔内狭窄切开，其中23例行经皮肾穿刺输尿管镜下钬激光顺行切开(同期行肾结石碎石取石8例)，38例行输尿管镜下逆行切开，均放置2或3根F6双J管。结果61例手术均顺利完成，手术时间30~78 min，平均53 min。术中无严重并发症，术后血尿1例，腰痛伴体温≥38.5 ℃ 5例，明显尿频尿急3例。12周后拔除双J管，继续观察6个月，53例肾积水消失，1例肾积水与术前比较无变化，7例肾积水逐渐加重，其中3例再次在输尿管镜下扩张置管。一期有效率869%(53/61)，二期总有效率91.8%(56/61)，拔除双J管后随访12～24个月，(15.8±3.7)月，再未出现肾积水加重。结论输尿管狭窄行腔内钬激光切开后放置多根双J管，安全可行，效果满意。
Abstract:
ObjectiveTo investigate the efficacy of multiple doubleJ tubes in intraluminal holmium laser incision of ureteral stricture.MethodsFrom January 2017 to December 2020, 61 patients with benign ureteral stricture were received intraluminal treatment. There were 23 patients who underwent percutaneous nephrolithotomy and holmium laser anterograde incision under ureteroscopy (8 patients underwent renal stone lithotripsy simultaneously) and 38 patients underwent retrograde incision under ureteroscope. A total of 2 or 3 F6 doubleJ tubes were placed in the ureter.ResultsAll the 61 operations were successfully completed. The operation time was 30-78 min, with an average of 53 min. There were no serious complications during the operation. Postoperative hematuria occurred in 1 case, low back pain with body temperature ≥38.5 ℃ in 5 cases, and obvious frequent and urgent urination in 3 cases. After 12 weeks, the doubleJ tubes were removed and the patients were further observed for 6 months. A total of 53 cases of hydronephrosis disappeared, 1 case of hydronephrosis had no change compared with that before operation, and 7 cases of hydronephrosis gradually aggravated, 3 of which were cured after dilation and catheterization under ureteroscopy. The effective rate of primary operation was 86.9% (53/61), and that of secondary operation was 91.8% (56/61). The patients were followed up for 12-24 months (mean, 15.8±3.7 months) after doubleJ tubes removal. There was no further aggravation of hydronephrosis.ConclusionIt is safe and feasible to place multiple doubleJ tubes in holmium laser incision of ureteral stricture.

参考文献/References:

[1]李柳林,孔垂泽,刘贤奎,等.输尿管镜下逆行球囊扩张术治疗良性输尿管狭窄的临床研究.中华腔镜泌尿外科杂志(电子版),2019,13(2):85-90.
[2]刘广,汤元杰,胡有根,等.输尿管镜钬激光与冷刀内切开治疗输尿管狭窄的疗效比较.医学研究生学报,2019,32(3):273-277.
[3]Lucas JW,Ghiraldi E,Ellis J,et al.Endoscopic management of ureteral strictures:an update.Curr Urol Rep,2018,19(4):24.
[4]钟铖,杨德林.输尿管狭窄诊疗进展.国际泌尿系统杂志,2017,37(1):136-138.
[5]刘勇刚,孙毅海.良性输尿管狭窄的临床研究及腔内治疗进展.微创医学,2018,13(4):485-487.
[6]赵永录,张兴盛,宋广智,等.多根DJ管置入在腔内治疗肾盂输尿管交接处狭窄的临床研究.世界最新医学信息文摘,2019,19(100):32-34.
[7]孙颖浩,主编.吴阶平泌尿外科学.北京：人民卫生出版社，2019.1013-1016，1047-1055
[8]黄健,主编.中国泌尿外科和男科疾病诊断治疗指南(2019版).北京：科学出版社，2019.681-684.
[9]吴昊,刘川,胡自力,等.经皮肾穿刺顺行球囊扩张术与开放手术治疗输尿管狭窄的meta分析.现代医药卫生,2019,35(9):1331-1335.
[10]何永忠,李逊,杨炜青,等.电刀内切开联合球囊扩张治疗输尿管狭窄.中华腔镜泌尿外科杂志(电子版),2017,11(2):113-117.
[11]袁琳,顾晓箭,朱清毅,等.钬激光经输尿管镜手术治疗输尿管狭窄(附52例报告).中国微创外科杂志,2008,8(10):883-884，894.
[12]刘永达,袁坚,李逊,等.腔内泌尿外科技术治疗输尿管狭窄.中华泌尿外科杂志,2006,27(9):608-611.
[13]温晖,黄炳福,陈少雄,等.腔内三重双J管引流技术治疗输尿管狭窄.中国微创外科杂志,2004,4(5):414-415.
[14]Ibrahim HM，Mohyelden K，AbdelBary A，et al.Single versus double ureteral stent placement after laser endoureterotomy for the management of benign ureteral strictures:a randomized clinical trial.J Endourol,2015,29(10):1204-1209.
[15]吴海严,郑鹏,程文,等.经尿道冷刀切开治疗输尿管膀胱壁间段狭窄.中国微创外科杂志,2019,19(1):90-92.
[16]惠强,秦荣良,高学林,等.球囊扩张术治疗继发性输尿管狭窄疗效分析.现代泌尿外科杂志,2020,25(3):225-229.
[17]谢宗兵,许可慰,陈启彪,等.双J管留置时间及大小对输尿管镜下输尿管狭窄内切开预后的影响.中华腔镜泌尿外科杂志(电子版),2011,5(5):400-403.
[18]蔡忠林,李文娟,周川,等.球囊扩张术与钬激光内切术治疗继发性输尿管狭窄的对比研究.中国内镜杂志,2017,23(6):16-20.
[19]佟杨,张大田,田洪阳,等.双“DJ”管在预防复杂性输尿管结石钬激光碎石术后狭窄的应用.中国现代手术学杂志,2020,24(2):141-145.
[20]刘杰,薛江辉,冉光勇,等.同侧两根双J管引流在结石伴息肉导致输尿管狭窄患者中的应用.中华腔镜泌尿外科杂志(电子版),2019,13(4):251-254.
[21]Reus C,Brehmer M.Minimally invasive management of ureteral strictures:a 5year retrospective study.World J Urol，2019，37(8):1733-1738.

备注/Memo

备注/Memo:
基金项目：武威市科技计划项目(ww170325) **通讯作者，Email：zhaoylurol@163.com
更新日期/Last Update: 2022-10-11