摘要
目的探讨一种输尿管口在难辨认情况下更换双J管的新方法的价值。方法本组选择了因不同原因造成输尿管口难辨认的15例患者,如果沿用传统的换管方法,拔除旧双J管后很可能导致输尿管口立刻被周围组织覆盖,置换新双J管将会极其困难,因此我们尝试了一种新的插管方法更换双J管,操作要点为:膀胱镜下逆行把新双J管沿旧管边自输尿管口向上插至肾盂,然后拔除输尿管内原双J管。结果本组15例患者19支双J管中16支顺利插入成功,无输尿管穿孔,出血等操作并发症。结论该方法简单安全,降低了插管难度,在没有增加创伤情况下解决了晚期膀胱肿瘤、重度腺性膀胱炎等病例更换双J管困难的问题,在难辨认输尿管口的情况下更换双J管可作为一种选择。
Objective Patients with advancedl bladder carcinoma,severe cystitis glandularis have to maintain ureteral stent for a long period of time.For these patients,replace the double-J stent cystoscopically is a normal procedure,but the ureteral orifice would be capped with surroundings immediately after the removal of former stent with the regular approach,in this study,we introduce a modified method for replacement of double-J stent in these cases which ureteral orifice is difficult to identify.Methods From 2003,15 cases with 19 stent were replaced with the modified procedure,mean age 47.2 years old（range 19-76）,8 male and 7 female patients,the mean period between the previous insertion of double-J stent and replacement was 4.5 month（range 1 to 12 month）,the ureteral orifice was difficult to identify under the cystoscope.We inserted the new double-J stent along with the former one up to the renal pelvis,then remove the former one.Results 16 of 19 stents were inserted successfully without ureteral perforation,bleeding and other complications occurred.Conclusion The modified replacement of double-J stent is safe and feasible,and is a valuable alternative for those patient who has to maintain the ureteral stent for a long time while the ureteral orifice is difficult to identify.
出处
《中华腔镜泌尿外科杂志（电子版）》
2010年第4期23-24,共2页
Chinese Journal of Endourology(Electronic Edition)
关键词
输尿管
双J管
膀胱镜
Bladder endoscopic Double-J tube Ureteral orifice Catheterization
