网鱼法与传统异物钳钳夹双J管拔管法在低龄病例中的疗效比较

曾林山 曾强 陈俊敏 刘金平 傅忠

【摘要】 目的：比較自创网鱼法与传统异物钳钳夹双J管拔管法在低龄病例中的疗效差异。方法：选择2019年3月-2020年3月本院120例单侧输尿管置入双J管儿童，采用单盲随机数字表法分为网鱼法组和传统法组，每组60例。比较两组手术时间、手术成功率、肉眼血尿发生率、泌尿系感染、损伤发生率、术前1 d和术后3 d尿常规红细胞计数及术后3、7 d疼痛评分。结果：两组手术时间和手术成功率比较，差异均无统计学意义（P>0.05）。网鱼法组肉眼血尿发生率低于传统法组（P<0.05）。术前1 d，两组尿常规红细胞计数比较，差异无统计学意义（P>0.05）;术后3 d，两组尿常规红细胞计数均高于术前1 d，但网鱼法组低于传统法组（P<0.05）。两组泌尿系感染、损伤发生率比较，差异均无统计学意义（P>0.05）。网鱼法组术后3、7 d疼痛评分均低于传统法组（P<0.05）。结论：网鱼法双J管拔管法在低龄病例中有较好的安全性和有效性，可降低尿路损伤，有较好的创新性和可推广性。

【关键词】 网鱼法 双J管 肉眼血尿

Comparison of the Curative Effect of Net Fish Method and Traditional Foreign Body Clamp with Double J Tube Extubation in Young Patients/ZENG Linshan， ZENG Qiang， CHEN Junmin， LIU Jinping， FU Zhong. //Medical Innovation of China， 2021， 18（16）： 0-050

[Abstract] Objective： To compare the effect of self-made net fish method and traditional foreign body clamp with double J tube extubation method in young patients. Method： A total of 120 children with unilateral ureteral insertion double J tube in our hospital from March 2019 to March 2020 were selected. They were divided into net fish method group and traditional method group by single-blind random number table method， 60 cases in each group. The operation time， surgical success rate， gross hematuria rate， urinary tract infection rate， injury rate were compared between two groups， routine urinary erythrocyte count 1 d before operation and 3 d after operation and pain scores 3 d and 7 d after operation were compared between the two groups. Result： There were no significant differences in operation time and surgical success rate between two groups （P>0.05）. The gross hematuria rate of net fish method group was lower than that of traditional method group （P<0.05）. 1 d before operation， there was no significant difference in the routine urinary erythrocyte count between two groups （P>0.05）; 3 d after operation， the routine urinary erythrocyte count of two groups were higher than those before operation， and net fish method group was lower than that of traditional method group （P<0.05）. There were no differences in the incidence of urinary tract infection rate and injury rate between two groups （P>0.05）. The pain scores of the fish net method group were lower than those of traditional method group at 3 and 7 days after operation （P<0.05）. Conclusion： The double-J tube extubation method with net fish has better safety and effectiveness in young patients， can reduce urinary tract injury， and has better innovation and popularization.

[Key words] Net fish method Double J tube Gross hematuria

First-author’s address： First Affiliated Hospital of Gannan Medical University， Ganzhou 341000， China

doi：10.3969/j.issn.1674-4985.2021.16.011

目前临床上输尿管留置双J管病人众多，其中低龄患者（年龄小于7周岁）占10%～35%[1]。传统拔管通常经尿道置入恰当管径的输尿管镜，镜下采用异物钳经活动手柄控制钳夹的开合，同时钳夹双J管取出。但是儿童输尿管生理管径较成人更细，常常需要置入最小管径的输尿管镜，此时往往无法放置合适尺寸的异物钳，取双J管更是困难，急需一种易于操作，安全性高，对患者痛苦小、尿路损伤小，便于临床推广应用的方法[2-3]。笔者由传统环套式经B超监视下拔除双J管的启发自主研究设计了一种网鱼法取双J管，在临床中应用发现有较好的安全性和可行性。……