刘杰+王伟+李刚

[摘要] 目的 探讨输尿管硬镜扩张后留置单根和双重双J管对复发性良性输尿管狭窄的疗效。 方法 选择2012年1月～2016年12月广西壮族自治区柳州市人民医院泌尿外科收治的复发性良性输尿管狭窄患者26例为研究对象，按照随机数字表分为单根双J管组和双重双J管组，每组各13例。比较两组临床疗效及置管前、置管后3个月两组患者血肌酐和肾积水的变化。 结果 置管后双重双J管组总有效率高于单根双J管组，但差异无统计学意义（P > 0.05）。置管前后两组肌酐水平组内和组间比较，差异均无统计学意义（P > 0.05）。置管前后单根双J管组肾积水比较，差异无统计学意义（P > 0.05）；置管后双重双J管组肾积水低于置管前和单根双J管组，差异均有统计学意义（P < 0.05）。 结论 对于复发性良性输尿管狭窄患者，放置双重双J管安全有效，引流效果优于留置单根双J管，但远期效果和机制需要大样本进一步研究验证。

[关键词] 支架；输尿管狭窄；引流

[中图分类号] R693.2 [文献标识码] A [文章编号] 1673-7210（2018）01（c）-0056-04

[Abstract] Objective To explore the efficacy of single versus double J ureteral stent placement in the treatment of recurrent benign ureteral stricture. Methods From January 2012 to December 2016， 26 patients with recurrent benign ureteral stricture in the Department of Urology， Liuzhou General Hospital， Guangxi Zhuang Autonomous Region were selected as the research objects and divided into the single J ureteral stent group and the double J ureteral stent group by random number table. The clinical efficacy was compared between the two groups after stent placement. Before and after 3 months of stent placement， the levels of serum creatinine and hydronephrosis were compared between the two groups. Results After stent placement， the total effective rate in double J ureteral stent group was higher than that in single J ureteral stent group， but with no statistically significant difference （P > 0.05）. Before and after stent placement， there were no statistically significant differences in the levels of serum creatinine between the two groups and within groups （P > 0.05）. In the single J ureteral stent group， there was no statistically significant difference in hydronephrosis before and after stent placement （P > 0.05）， but after stent placement， that in the double J ureteral stent group was lower than that of before stent placement and that in the single J ureteral stents group， with statistically significant differences （P < 0.05）. Conclusion The efficacy and the drainage of double J ureteral stent placement in the treatment of recurrent benign ureteral stricture are better than those of single J ureteral stent placement. However， the long-term effects and mechanisms need to be further studied and verified by large samples.

[Key words] Stent； Ureteral stricture； Drainage

輸尿管狭窄是泌尿外科常见疾病之一，随着微创器械的改进和经验的积累，输尿管狭窄的治疗已经由微创技术取代了传统的开放手术。输尿管狭窄的微创治疗方法比较多，如球囊扩张、内切开术、金属支架置入、腹腔镜或机器人辅助下手术等[1-4]，均有一定的临床效果，但仍有部分患者术后再次发生输尿管狭窄。对复发性良性输尿管狭窄，输尿管硬镜扩张后留置双J管是可选择的治疗方法之一。本研究选取了部分复发性良性输尿管狭窄患者，对留置双重双J管和留置单根双J管引流效果进行比较。现报道如下：endprint

1 资料与方法

1.1 一般资料

选择2012年1月～2016年12月在广西壮族自治区柳州市人民医院（以下简称“我院”）泌尿外科住院治疗的复发性良性输尿管狭窄患者26例，按照随机数字表法分为单根双J管组和双重双J管组，每组各13例。其中单根双J……