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肾镜在恶性肿瘤压迫致输尿管梗阻留置双J管中的应用 预览

Application of nephroscope in the placement of double J ducts in ureteral obstruction caused by compression of malignant tumor
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摘要 目的探讨肾镜在恶性肿瘤压迫致输尿管梗阻留置双J管中应用的有效性及安全性。方法膀胱外恶性肿瘤压迫致输尿管梗阻患者60例随机分为观察组、对照1组、对照2组,每组20例,分别采用经肾镜向患侧输尿管留置双J管、经输尿管镜向患侧输尿管留置双J管、经膀胱镜向患侧输尿管留置双J管,比较3组置管成功率,分析血肌酐、血尿素氮及血钾下降幅度,观察并发症发生情况。结果观察组置管成功率明显高于对照组1组、2组患者,差异有统计学意义(P<0.05)。治疗1周后,3组患者血肌酐、血尿素氮及血钾均较治疗前明显下降(P<0.05),且观察组下降幅度大于对照1组和对照2组(P<0.05)。随访半年,观察组尿路感染、出血发生率、尿道狭窄均低于对照1组和对照2组(P<0.05)。结论经肾镜向患侧输尿管留置双J管在解决恶性肿瘤对输尿管压迫所致的梗阻时成功率高、并发症低、肾功能改善明显,满意度高,操作简单方便,临床意义重大。 Objective To explore the efficacy and safety of application of nephroscope in the placement of double J ducts in ureteral obstruction caused by compression of malignant tumor.Methods Sixty patients with ureteral obstruction caused by external bladder malignant tumor who were treated in our hospital were divided into observation group,control group 1 and control group 2,with 20 cases in each group.The patients in the three groups were treated by double J tube indwelling ureteral via nephroscope,ureteroscopy to the affected side ureter,double J tube by cystoscope to the infected ureter,respectively.The success rate of catheterization was compared among the three groups.Moreover the levels of blood creatinine,blood urea nitrogen and potassium as well as the incidence rate of complications were observed and compared among the three groups.Results The success rate of catheterization in observation group was significantly higher than that in control groups 1 and control group 2(P<0.05).After 1-week treatment,the levels of blood creatinine,blood urea nitrogen and blood potassium were significantly decreased in the three groups,as compared with those before treatment(P<0.05),moreover,the decrease extent in observation group was greater than that in control group 1 and control group 2(P<0.05).After 6-month follow up,the incidence rates of urinary tract infection,bleeding and urethral stricture in observation group were significantly lower than those in control group 1 and control group 2(P<0.05).Conclusion The ureteral indwelling double J tube via nephroscope has higher success rate,lower incidence rate of complication,which can obviously improve renal function,with high satisfaction degree,simple and convenient operationmtherefor,it is of great significance in clinical practice.
作者 李金明 白续国 LI Jinming;BAI Xuguo(Department of Pelvic Urology,Cancer Hospital of Xingtai City,Hebei,Xingtai 054001,China)
出处 《河北医药》 CAS 2019年第2期233-236,共4页 Hebei Medical Journal
关键词 双J管 肾镜 输尿管镜 膀胱镜 输尿管梗阻 经皮肾穿刺术 double J tube nephroscope ureteroscope cystoscope ureteral obstruction percutaneous nephrolithotomy
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