医学综述
醫學綜述
의학종술
MEDICAL RECAPITULATE
2014年
24期
4568-4569
,共2页
输尿管镜%钬激光%双J管%并发症%危险因素
輸尿管鏡%鈥激光%雙J管%併髮癥%危險因素
수뇨관경%화격광%쌍J관%병발증%위험인소
Ureterscopic lithotripsy%Holmium-laser%Double-J ureteral stent%Complications%Risk fac-tor
目的：研究分析输尿管镜钬激光碎石术后留置双J管并发症的危险因素。方法选择2010年11月至2013年2月于重庆市九龙坡区第一人民医院泌尿外科进行输尿管镜钬激光碎石术，并在术后留置双J管的患者153例，对其临床资料进行回顾性分析，对可能导致留置双J管后发生并发症的危险因素进行Logistic回归分析。结果153例患者留置双J管后发生并发症106例，发生率为69.3%。多危险因素回归分析表明，反复血尿的危险因素为双J管长度≥26 cm、留置时间≥4周和每日饮水量≤1200 mL；膀胱刺激征的危险因素为双J管长度≥26 cm、每日饮水量≤1200 mL和未有药物干预；双J管异位的危险因素为双J管长度<26 cm和留置时间≥4周；腰痛的危险因素为双J管长度≥26 cm。结论双J管长度选择不当是最大的危险因素，而双J管留置时间过久、患者饮水不足、未有药物干预也是并发症的重要危险因素。
目的：研究分析輸尿管鏡鈥激光碎石術後留置雙J管併髮癥的危險因素。方法選擇2010年11月至2013年2月于重慶市九龍坡區第一人民醫院泌尿外科進行輸尿管鏡鈥激光碎石術，併在術後留置雙J管的患者153例，對其臨床資料進行迴顧性分析，對可能導緻留置雙J管後髮生併髮癥的危險因素進行Logistic迴歸分析。結果153例患者留置雙J管後髮生併髮癥106例，髮生率為69.3%。多危險因素迴歸分析錶明，反複血尿的危險因素為雙J管長度≥26 cm、留置時間≥4週和每日飲水量≤1200 mL；膀胱刺激徵的危險因素為雙J管長度≥26 cm、每日飲水量≤1200 mL和未有藥物榦預；雙J管異位的危險因素為雙J管長度<26 cm和留置時間≥4週；腰痛的危險因素為雙J管長度≥26 cm。結論雙J管長度選擇不噹是最大的危險因素，而雙J管留置時間過久、患者飲水不足、未有藥物榦預也是併髮癥的重要危險因素。
목적：연구분석수뇨관경화격광쇄석술후류치쌍J관병발증적위험인소。방법선택2010년11월지2013년2월우중경시구룡파구제일인민의원비뇨외과진행수뇨관경화격광쇄석술，병재술후류치쌍J관적환자153례，대기림상자료진행회고성분석，대가능도치류치쌍J관후발생병발증적위험인소진행Logistic회귀분석。결과153례환자류치쌍J관후발생병발증106례，발생솔위69.3%。다위험인소회귀분석표명，반복혈뇨적위험인소위쌍J관장도≥26 cm、류치시간≥4주화매일음수량≤1200 mL；방광자격정적위험인소위쌍J관장도≥26 cm、매일음수량≤1200 mL화미유약물간예；쌍J관이위적위험인소위쌍J관장도<26 cm화류치시간≥4주；요통적위험인소위쌍J관장도≥26 cm。결론쌍J관장도선택불당시최대적위험인소，이쌍J관류치시간과구、환자음수불족、미유약물간예야시병발증적중요위험인소。
Objective To study and investigate the risk factors of the complications of double-J ureteral stent indwelling after ureteroscopic holmium-laser lithotripsy. Methods Clinical data of 153 patients treated with ureteroscopic holmium-laser lithotripsy and indwelled double-J stent in Jiulongpo First People′s Hospital from Nov. 2010 to Feb. 2013 was retrospectively analyzed to identify the risk factors of the complications of double-J ureteral stent indwelling by Logistic regression method. Results Among all the 153 cases,compli-cations of double-J ureteral stent occurred in 106 patients(69. 3%). Results of multifactor analysis indicated that the risk factors of recurrent hematuria were the length of double-J ureteral stent≥26 cm,stent duration≥4 w and daily water intake≤1200 mL. Bladder irritation was associated with length of double-J ureteral stent≥26 cm,daily water intake≤1200 mL and none-drug intervention. Risk factors linked with ectopic double-J ureteral stent included length of double-J ureteral stent<26 cm and stent duration≥4 w. Additionally,length of double-J ureteral stent≥26 cm contributed to lumbago. Conclusion The improper selection of the length of double-J ureteral stent is the biggest risk factor of complications after ureteroscopic holmium-laser lithotrip-sy. Long duration of stent indwelling,subimbibition and none-drug intervention are also important risk factors of complications.
