带双线输尿管支架管在上尿路手术中的应用

摘要

Objective To explore the clinical value of Ureteral Stents with dual lines in upper urinary tract surgery. Methods Of 71 cases undergoing upper urinary tract surgery patients randomly divided into two groups. Traditional Ureteral Stents were used in 1th group of 34 cases,and cystoscopy was used for extubation postoperatively; while Ureteral Stents with dual lines were used in 2nd group of 37 cases,and postoperatively extubation via traction of silk thread. Compared success rate of extubation,the incidence of postoperative wound and urinary tract infection,as well as the incidence of urinary tract infection and bleeding after extubation in patients with both groups. Results 3 cases in lth group were failed in pulling the tube, while in 2nd group,only 1 case was failed, but the difference had no statistics significance(P＞0. 05). No wound infections were detected in both two groups, 1 case of urinary tract infection was found in both group respectively,but the difference had either no statistics significance(P＞0. 05). In lth Group 2 cases appears with urinary tract infection and 13 cases of hematuria occurred after extubation, while none happened in 2nd Group, differences were statistically significant(P＜0. 05). Conclusion Application of Ureteral Stents with dual lines in upper urinary tract surgery, while not significantly improve the success rate of extubation,but can reduce the incidence of injury and infection of the urinary tract,alleviate the suffering of patients accepted invasive operation and economic burden, without increasing the occurrence of postoperative wound infections,especially with BPH or urethral stricture in special cases,has a certain value of clinical application.%目的 探讨带双线输尿管支架管在上尿路手术中的应用.方法 将71例接受上尿路手术的患者随机分为两组.第1组34例患者使用传统输尿管支架管,术后予膀胱镜拔管;第2组37例患者使用带双线输尿管支架管,术后予牵拉患者尿道口外的丝线拔管.比较两组患者拔管成功率、术后伤口及尿路感染的发生率,以及拔管后尿路感染及出血的发生情况.结果 第1组患者中3例拔管不成功(成功率为91.18%),第2组患者中1例拔管失败(成功率为97.30%),两组比较差异无统计学意义(P>0.05);两组患者术后均未出现伤口感染,而第1组患者中1例患者出现术后尿路感染(发生率为2.94%),第2组患者中亦有1例出现尿路感染(发生率为2.70%),两组比较差异无统计学意义(P>0.05).第1组患者中2例出现拔管后尿路感染(发生率为5.88%),13例出现拔管后肉眼血尿(发生率为38.24%),而第2组患者均未出现拔管后尿路感染及肉眼血尿的情况,差异均有统计学意义(P<0.05).结论 上尿路手术应用带双线输尿管支架管,虽然不能显著提高拔管成功率,但可减少尿路损伤及感染的发生,减轻患者接受侵入性操作的痛苦和经济负担,而不增加术后伤口感染的发生,尤其在伴有前列腺增生或尿道狭窄等特殊的病例中,具有一定的临床应用价值.