经皮肾碎石取石术后输尿管双J管留置时间和拔管方法的探讨

周厚勇; 邓建平; 张恒; 王永权; 李龙坤

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经皮肾碎石取石术后输尿管双J管留置时间和拔管方法的探讨

论著 | 更新时间：2026-01-09

- 经皮肾碎石取石术后输尿管双J管留置时间和拔管方法的探讨
- Investigation on the different indwelling time and removal methods for double-pigtail stent after PCNL
- 陆军军医大学学报 2012年34卷第6期页码：564-566
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  中图分类号： R472.92;R693.4;R699.1
- 纸质出版：2012
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周厚勇,邓建平,张恒,王永权,李龙坤.经皮肾碎石取石术后输尿管双J管留置时间和拔管方法的探讨[J].陆军军医大学学报(原第三军医大学学报),2012,34(06):564-566.

　Zhou Houyong,Deng Jianping,Zhang Heng,Wang Yongquan,Li Longkun.Investigation on the different indwelling time and removal methods for double-pigtail stent after PCNL[J].J Amry Med Univ (J Third Mil Med Univ),2012,34(06):564-566.
周厚勇,邓建平,张恒,王永权,李龙坤.经皮肾碎石取石术后输尿管双J管留置时间和拔管方法的探讨[J].陆军军医大学学报(原第三军医大学学报),2012,34(06):564-566. DOI：

　Zhou Houyong,Deng Jianping,Zhang Heng,Wang Yongquan,Li Longkun.Investigation on the different indwelling time and removal methods for double-pigtail stent after PCNL[J].J Amry Med Univ (J Third Mil Med Univ),2012,34(06):564-566. DOI：

摘要

目的对经皮肾碎石取石术（percutaneous nephrolithotomy，PCNL）后患者输尿管双J管留置时间长短及拔管方法进行探讨。方法 84例行PCNL治疗的上尿路结石患者完全随机分为3组：长期留置组（n=28），术后留置输尿管双J管4～6周，经尿道膀胱镜下拔管；短期留置组（n=28），术后留置输尿管双J管8～12 d，经尿道膀胱镜下拔管；短期留置改良组（n=28），术后留置输尿管双J管8～12 d，经肾穿刺通道用改良方法拔管。3组患者于拔管后和出院后分别填写问卷调查，手术后1个月复查肾功能和利尿肾图。结果患者出院后肉眼血尿、腰胀、膀胱刺激征、泌尿系感染、发热、双J管移位、尿液反流等并发症发生率，长期留置组分别与短期留置改良组、短期留置组间存在显著差异（P0.05），短期留置组与短期留置改良组间无明显差异(P0.05)。患者拔管后尿道疼痛、肉眼血尿、尿道损伤、膀胱刺激征、泌尿系感染、发热等并发症发生率，短期留置改良组分别与长期留置组、短期留置组间均存在显著差异（P0.05），长期留置组与短期留置组间无明显差异(P0.05)。手术后1个月复查肾功能、利尿肾图，3组间差异无统计学意义(P0.05)。结论经皮肾碎石取石术后8～12 d，有针对性采用改良方法拔管，可有效缩短双J管的留置时间，避免因带管出院及置管时间过长引起的并发症，减少患者的费用和痛苦，值得临床推广使用。

Abstract

Objective To investigate the effect of different indwelling time and removal methods for double-pigtail stent after percutaneous nephrolithotomy (PCNL). Methods Eighty-four patients with upper urinary tract lithiasis were randomly divided into three groups including a long-time group (double-pigtail stent indwelled for 4 to 6 weeks and removed with conventional method under cystoscope

n=28)

a short-time group (double-pigtail stent indwelled for 8 to 12 d and removed with conventional method under cystoscope

n=28)

and an improved short-time group (double-pigtail stent indwelled for 8 to 12 d and removed with improved method through renal tract). All of the patients received questionnaire survey after removal of double-pigtail stent and discharge. The renal function and diuresis renogram of the patients were reexamined at 1 month after operation. Results The incidences of the complications after removal of double-pigtail stent including urethralgia

gross hematuria

urethral injury

irritation symptoms of bladder

urinary infection and fever in the improved short-time group were significantly lower than those in the long-time group and the short-time group (P0.05)

but the differences between the long-time group and the short-time group were not significant (P0.05). The incidences of the complications after discharge including gross hematuria

lumbar distending pain

irritation symptoms of bladder

urinary infection

fever

double-pigtail stent migration and vesicoureteric reflux in the long-time group were significantly higher than those in the short-time group and the improved short-time group (P0.05)

but the differences between the improved short-time and the short-time group were not significant (P0.05). The reexamination showed no significant differences of renal function and diuresis renogram among the three groups. Conclusion The application of improved removal method after 8-12 d PCNL should be recommended for its short indwelling time

low cost and few complications.

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