利用金属导尿管支架经女性尿道取出双 J 管的效果研究

摘要

Objectives:To evaluate the feasibility and safety of transurethral double -J tubes withdrawing of female by metal catheter stents.Methods:The clinical data of 310 female patients with urinary surgery indwell-ing double J tubes after surgery,from March 2012 to September 2014,were analyzed retrospectively and divided into group A (by metal catheter stents,140 cases)and group B (under the cystoscopy,170 cases).Operation time and incidence rate of complications of the two groups were compared.Results:Successful primary removal rate was 98. 6% (138 cases)in group A,including 3 cases of gross hematuria (2.1%),63 cases of irritation signs of bladder (45.7%),with the average operation time of (3.3 ±0.5)min,the evaluation of postoperative pain of 1.95 ±1.28) points and average expenditure of (37.8 ±9.2)yuan.The recovery time was (4.8 ±1.2)days in average.Compared with group B,group A had a relatively short operation time,lower pain degree,less expenditure and recovery time (P<0.05).There were no significant differences between two groups in the incidence rate of irritation signs of bladder and gross hematuria.Conclusions:The use of metal catheter stents in withdrawing double J tubes through female ure-thra can directly increase the success rate,with no significant complications,and decrease the patients’economic burden and the influence of sexual life,as well as simplifying operations which is worth being generalized.%目的：探讨金属导尿管支架经女性尿道取出双 J 管的可行性及安全性。方法：回顾性分析我院泌尿外科2012年3月至2014年9月住院手术后留置双 J 管的女性患者310例，其中利用金属导尿管尿管支架经女性尿道拔除双 J 管患者140例（A 组），与同期行经膀胱镜双 J 管取出女性患者170例（B 组）进行对比，比较两组操作时间及并发症发生率。结果：A 组一次性取管138例，成功率98．6％，操作时间（3．3±0．5）min，术后并发肉眼血尿3例（2．1％）；出现膀胱刺激症状63例（45．7％），术后疼痛评估（1．95±1．28）分，平均医疗费用（37．8±9．2）元，平均恢复正常性生活时间（4．8±1．2）d；B 组全部成功取管，平均操作时间（10．6±4．5）min，术后并发肉眼血尿5例（1．8％），出现膀胱刺激症状95例（55．9％），术后疼痛评估（3．59±1．50）分，平均医疗费用（325．6±11．7）元，平均恢复正常性生活时间（8．5±2．3）d。A 组较 B 组操作时间短，疼痛评分低，医疗费用支出少，恢复正常性生活时间短，P ＜0．05，膀胱刺激症状及肉眼血尿发生率两组无显著性差异。结论：用金属导尿管支架经女性尿道取出双 J 管成功率高，操作简便，无严重并发症发生并可减低患者医疗费用支出，对性生活影响小，值得临床推广。