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目的:探讨输尿管双J和单J内支架管对治疗后患者侧腹痛、下尿路症状和生活质量的影响。方法:本研究包括40例成人经皮肾取石(PCNL)术后放置输尿管内支架管的患者。病人随机分为相同数量的2组,组1放置单J输尿管内支架管,近端位于肾脏下盏,下端跨过骶髂关节上缘未进入膀胱。组2放置双J输尿管内支架管,近端位于肾脏下盏,远端在膀胱内。支架管置入25～40 d后病人回答一份关于侧腹痛、排尿困难、尿急、以及生活质量的问卷。结果:活动时侧腹痛,组1有18例(90%),组2有19例(95%),两组差别无显著性(P>0.05)。组1有2例(10%)、组2有14例(70%)有轻度的侧腹痛,多在排尿过程中出现。两组在疼痛程度上差别有显著性(P<0.001)。组1有1例(5%)有排尿困难,组2有3例(15%)有重度排尿困难(P<0.001)。组1有4例(20%)有尿急症状,组2有17例(85%)有中重度尿急症状(P<0.001)。组1的病人报告生活质,仅有1例(5%)感到中度的苦恼,而组2中有5例(25%)感到中、重度苦恼(P<0.001)。结论:输尿管支架管与腰痛和下尿路症状有关。留置内支架管有活动时腰痛。双J内支架管较单J内支架管的患者更容易出现排尿时腰痛、尿急、排尿困难和生活质量的降低。
Objective: To investigate the effect of ureter double J and single J stent on the patients with side abdominal pain, lower urinary tract symptoms and quality of life after treatment. Methods: This study included 40 patients with percutaneous nephrolithotomy (PCNL) who underwent ureteral stent placement. Patients were randomly divided into the same number of 2 groups, group 1 placed a single J ureteral stent tube, the proximal end of the lower kidney, the lower edge of the sacroiliac joint did not enter the upper edge of the bladder. Group 2 placed double J ureteral stent tube, the proximal is located in the lower kidney, the distal in the bladder. After 25 to 40 days of stent placement, the patient answered a questionnaire about side abdominal pain, dysuria, urgency, and quality of life. Results: There were 18 cases (90%) in group 1 and 19 cases (95%) in group 2, with no significant difference between the two groups (P> 0.05). Group 1 had 2 cases (10%), Group 2 14 (70%) had mild side abdominal pain, mostly in the urination process. There was a significant difference in the degree of pain between the two groups (P <0.001). One patient (5%) had dysuria in group 1 and three patients (15%) had dysuria (p <0.001) in group 2. In group 1, 4 patients (20%) had urinary urgency and in group 2 17 (85%) had moderate-to-severe urinary urgency (P <0.001). Patients in group 1 reported modest distress in only one patient (5%), and moderate and severe distress in five patients (25%) in group 2 (P <0.001). Conclusion: Ureteral stent is associated with low back pain and lower urinary tract symptoms. Indwelling stent activities have low back pain. Patients with double-J stent stents were more prone to lower back pain, urinary urgency, dysuria, and quality of life when urinating than patients with single-J stent stents.