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放置双J管治疗头孢曲松相关性尿路梗阻

The management of ceftriaxone associated ureteral obstruction by Double-J catheter stenting
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摘要 目的 探讨放置双J管在头孢曲松相关性尿路梗阻中的应用及疗效.方法 2006年1月-2014年5月行放置输尿管双J管治疗9例保守治疗无效的头孢曲松相关性尿路梗阻的患者.入院前行头孢曲松抗炎约2 -10d(平均4.5d)后,出现典型肾绞痛症状,术前疼痛视觉模拟评分为8.5±1.2分,经停用头孢曲松、解痉镇痛治疗无效.其中6例患者出现肾功能不全.结果 9例患者在膀胱镜下逆行置入输尿管双J管后肾绞痛症状均缓解.术后疼痛视觉模拟评分为3.5±0.6分,肾功能不全患者3-5d肾功能均达到正常水平.患者在两周左右拔出双J管,行泌尿系彩超未见明显结石及输尿管梗阻.3个月后复查泌尿系彩超未见明显结石及梗阻.结论 对保守治疗不能缓解的头孢曲松致尿路梗阻并发肾绞痛或肾功能不全的患者,置入输尿管双J管是一种简单而且有效的治疗方法. Objectives To evaluate the effectiveness and safety of placing double-J catheter for the management of ceftriaxone associated ureteral obstruction.Methods To analyse 9 cases with ceftriaxone associated ureteral obstruction who had no response to conservative treatment from January 2006 to May 2014,.All cases were treated by Double-J catheter stenting.The mean duration from the first day of ceftriaxone administration to typical renal colic was 4.5 days (range 2-10 days),which could not be relieved by either cessation of ceftriaxone or administration of antispasmodics and analgesics.Visual Analogue Scal (VAS) were 8.5 ± 1.2 before the operation.Results After the stenting process into the ureters by cystoscope,symptoms gradually alleviated and renal function recovered in all 9 cases,whose VAS were 3.5 ± 0.6.All the double-J catheter were removed two weeks after stenting when ultrasound examination showed no calculus or sign of ureteral obstruction.The same ultrasound results were got after 3 months of follow-up.Conclusions Retrograde ureteral catheterization is a simple and effective treatment of those who had renal colic or renal failure failed to respond to pharmacotherapy as the single method.
作者 林海岳 文定军 杨登峰 闫建涛 Lin Haiyue,Wen Dingjun, Yang Dengfeng, et al. ( Department of Transplantation and Urology, the No. 1 People Hospital of Yueyang, Yueyang 414000, China)
出处 《国际泌尿系统杂志》 2015年第2期253-256,共4页 International Journal of Urology and Nephrology
关键词 头孢曲松 肾功能不全 Ceftriaxone Renal Insufficiency
作者简介 通讯作者:文定军Email:329098686@qq.com
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