中国微创外科杂志
中國微創外科雜誌
중국미창외과잡지
Chinese Journal of Minimally Invasive Surgery
2015年
11期
1031-1033
,共3页
胡岩%齐灿%马立新%郭付臣
鬍巖%齊燦%馬立新%郭付臣
호암%제찬%마립신%곽부신
小儿%输尿管双J管%膀胱镜%麻醉%肾积水
小兒%輸尿管雙J管%膀胱鏡%痳醉%腎積水
소인%수뇨관쌍J관%방광경%마취%신적수
Pediatric%Ureteral double-J tube%Cystoscope%Anesthesia%Hydronephrosis
目的：探讨非膀胱镜非麻醉下小儿输尿管双J管取出术的可行性。方法2014年1月～2015年5月留置输尿管双J管患儿50例，年龄10个月～8岁，按随机数字表法随机分成改良组和传统组各25例。改良组水合氯醛灌肠镇静，用丝线圈经导尿管取出双J管；传统组静脉吸入复合麻醉，F6或F8膀胱镜下取出双J管。比较2组成功率、手术时间、住院时间、术后排尿不适以及镜下血尿等指标。结果改良组成功取出23例，失败2例，传统组25例均成功取出，二者成功率差异无统计学意义（Fisher检验，P＝0．490）。改良组和传统组手术时间分别为（14．3±3．6）和（40．2±4．1）min（t＝－23．630， P＝0．000），住院时间分别为（1．2±0．4）和（2．7±0．6）d（t＝－11．320，P＝0．000），术后排尿不适分别为1例（4％）和8例（32％）（χ2＝4．334，P＝0．037），镜下血尿分别为1例（4％）和9例（36％）（χ2＝5．484，P＝0．019），差异均具有统计学意义。结论非膀胱镜非麻醉下小儿输尿管双J管取出术安全、可行、有效，值得临床推广。
目的：探討非膀胱鏡非痳醉下小兒輸尿管雙J管取齣術的可行性。方法2014年1月～2015年5月留置輸尿管雙J管患兒50例，年齡10箇月～8歲，按隨機數字錶法隨機分成改良組和傳統組各25例。改良組水閤氯醛灌腸鎮靜，用絲線圈經導尿管取齣雙J管；傳統組靜脈吸入複閤痳醉，F6或F8膀胱鏡下取齣雙J管。比較2組成功率、手術時間、住院時間、術後排尿不適以及鏡下血尿等指標。結果改良組成功取齣23例，失敗2例，傳統組25例均成功取齣，二者成功率差異無統計學意義（Fisher檢驗，P＝0．490）。改良組和傳統組手術時間分彆為（14．3±3．6）和（40．2±4．1）min（t＝－23．630， P＝0．000），住院時間分彆為（1．2±0．4）和（2．7±0．6）d（t＝－11．320，P＝0．000），術後排尿不適分彆為1例（4％）和8例（32％）（χ2＝4．334，P＝0．037），鏡下血尿分彆為1例（4％）和9例（36％）（χ2＝5．484，P＝0．019），差異均具有統計學意義。結論非膀胱鏡非痳醉下小兒輸尿管雙J管取齣術安全、可行、有效，值得臨床推廣。
목적：탐토비방광경비마취하소인수뇨관쌍J관취출술적가행성。방법2014년1월～2015년5월류치수뇨관쌍J관환인50례，년령10개월～8세，안수궤수자표법수궤분성개량조화전통조각25례。개량조수합록철관장진정，용사선권경도뇨관취출쌍J관；전통조정맥흡입복합마취，F6혹F8방광경하취출쌍J관。비교2조성공솔、수술시간、주원시간、술후배뇨불괄이급경하혈뇨등지표。결과개량조성공취출23례，실패2례，전통조25례균성공취출，이자성공솔차이무통계학의의（Fisher검험，P＝0．490）。개량조화전통조수술시간분별위（14．3±3．6）화（40．2±4．1）min（t＝－23．630， P＝0．000），주원시간분별위（1．2±0．4）화（2．7±0．6）d（t＝－11．320，P＝0．000），술후배뇨불괄분별위1례（4％）화8례（32％）（χ2＝4．334，P＝0．037），경하혈뇨분별위1례（4％）화9례（36％）（χ2＝5．484，P＝0．019），차이균구유통계학의의。결론비방광경비마취하소인수뇨관쌍J관취출술안전、가행、유효，치득림상추엄。
Objective To investigate the feasibility of cystoscopic removal of pediatric ureteral double-J tube by means of operation without anesthesia. Methods We chose 50 children with ureteral double-J tube, aged between 10 months and 8 years old, from January 2014 to May 2015.The patients were randomly divided into two groups (25 cases in each group).The experimental group were given chloral hydrate composure by enema and the double-J tube was taken out by the urinary catheter with the surgical silk suture.In the control group, the double-J tube was taken out under cystoscope ( F6 or F8) in anesthesia.The success rate, operation time, hospital stay, postoperative urination discomfort and microscopic haematuria were compared between the two groups. Results The removal surgery was successfully accomplished in 23 cases in the experimental group, with 2 cases of failure.The removal was successfully completed in all the 25 cases in the control group.The success rates between the two groups were not significantly different ( P=0.490) .There were statistically significant differences between the experimental group and the control group in operation time [(14.3 ±3.6) min vs.(40.2 ±4.1) min, t=-23.630, P=0.000], hospital stay [(1.2 ±0.4) d vs.(2.7 ±0.6) d, t=-11.320, P=0.000], postoperative urination discomfort [1 case (4%) vs.8 cases (32%), χ2 =4.334, P =0.037] and microscopic haematuria [1 case (4%) vs.9 cases (36%),χ2 =5.484, P=0.019]. Conclusion Cystoscic removal surgery of pediatric ureteral double-J tube without anesthesia is safe, feasible, and effective, being worthy of clinical promotion.
