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目的比较跨吻合口支架管引流与双J管引流在儿童Anderson-Hynes术后的效果及两者的优缺点。方法回顾性分析2007年1月-2010年1月,52例因肾盂输尿管连接处狭窄(UPJO)并由同一位小儿泌尿外科医师行Anderson-Hynes术的患儿的临床资料,其中25例(48.1%)术后放置跨吻合口支架引流(跨吻合口支架管组),27例(57.9%)术后放置双J管引流(双J管组)。对2组患儿手术时间、住院天数、拔管时间、总的并发症和成功率进行比较。结果跨吻合口支架管组出现支架管滑脱1例,双J管组出现膀胱痉挛引起腹痛1例、膀胱内尿盐结垢1例。2组导尿管拔除时间[(2.1±0.7)dvs(4.4±1.1)d]、住院时间[(13.5±1.3)d vs(6.0±1.1)d]比较,差异均有统计学意义(Pa<0.01);而手术时间[(62.8±12.5)min vs(52.6±10.2)min]、肾周引流管拔除时间[(4.0±0.9)d vs(3.4±1.0)d]比较,差异均无统计学意义(Pa>0.05)。跨吻合口支架管拔除时间为(12.4±1.2)d,双J管拔除时间为(5.7±1.3)周。2组术后均未出现再次狭窄而手术的患者。结论两种支架管引流方式在术后总体并发症和成功率无明显差异,但跨吻合支架管引流具有操作简单、兼有内外引流及支撑作用、术后取管方便及经济等优点,最重要的是避免了再次麻醉下取管。
Objective To compare the effect of Anderson-Hynes pedicle screw drainage and double J-tube drainage in children after anastomosis and the advantages and disadvantages of both. Methods From January 2007 to January 2010, 52 patients (48.1) who underwent anderson-Hynes procedure with the pediatric urethral stricture (UPJO) and the same pediatric urologist were retrospectively analyzed. %) Were placed across the anastomotic stent drainage (across the anastomotic stent group), 27 patients (57.9%) were placed double J tube drainage (double J tube group). The operation time, hospitalization days, extubation time, total complication and success rate of two groups of children were compared. Results There were 1 case of stent slippage across the anastomotic stent tube group, 1 case of abdominal pain due to bladder spasm and 1 case of urinary salt scaling in the bladder. There were significant differences in the time of catheter removal between the two groups [(2.1 ± 0.7) d vs (4.4 ± 1.1) d] and hospital stay [(13.5 ± 1.3) d vs (6.0 ± 1.1) d] 0.01). However, there was no significant difference between the two groups in the time of operation [(62.8 ± 12.5) min vs (52.6 ± 10.2) min] and the drainage time of perirenal drainage tube [(4.0 ± 0.9) d vs (3.4 ± 1.0) d] Significance (Pa> 0.05). The time of detachment across the anastomotic stent was (12.4 ± 1.2) d, and the duration of double J tube removal was (5.7 ± 1.3) weeks. There was no restenosis in the two groups after operation. Conclusions There is no significant difference in overall postoperative complications and success rate between the two stent-graft methods. However, it is very important for the drainage tube to cross the anastomosis stent tube with the advantages of simple operation, both internal and external drainage and supportive functions, convenient postoperative tube-taking and economic advantages Is to avoid taking the tube under anesthesia again.