學術論壇
學術論壇可提供瀏覽者及一般會員閱讀瀏覽學術文章。
您必須為協會會員或專科醫師才可擁有發表文章及討論之權限。
您必須為協會會員或專科醫師才可擁有發表文章及討論之權限。
| 發表人 | 討論主題 | 發表時間 | 討論數 |
| 鄭詠庭 | 輸尿管鏡檢及放置JJ支架後的Foley導管使用：一項由歐洲泌尿外科學會結石病分會-青年學術泌尿外科醫師組織（EULIS-YAU）進行的隨機前瞻性內鏡泌尿學研究 | 2025/1/24 下午 05:39:58 | 0 |
| 原 文 | 題 目 | Foley catheter after ureteroscopy and JJ stent placement: a randomised prospective European Association of Urology Section of Urolithiasis-Young Academic Urologists (EULIS-YAU) endourology study |
| 作 者 | Tarik Emre Sener, Gunal Ozgur, Mehmet Cetin, Amelia Pietropaolo, Lazaros Tzelves, Francesco Esperto, Bhaskar Somani, Yiloren Tanidir | |
| 出 處 | BJU Int. 2025 Jan;135(1):95-102. doi: 10.1111/bju.16504. | |
| 出版日期 | 11 August 2024 | |
| 評 論 | 輸尿管鏡手術是一種微創的泌尿外科手術，通過天然孔洞的尿道進入膀胱，再沿著輸尿管進入腎臟進行檢查和治療輸尿管和腎臟內的相關問題，最常用於處理輸尿管結石、泌尿系腫瘤及輸尿管狹窄…等等。在輸尿管鏡術後有時會放置輸尿管內支架（雙J導管）用於緩解輸尿管阻塞並促進尿路的癒合和引流。同時，術後放置導尿管以維持膀胱壓力在所需的低水平亦是術後常見的常規處置之一，進而減少由雙J導管引起的輸尿管逆流以緩解術後腎積水和疼痛，並降低術後感染併發症的風險。然而，導尿管在術後早期引起不適可能增加病患的抱怨。輸尿管鏡手術是治療輸尿管/腎結石並放置雙J導管後，是否放置導尿管並無明確的循證依據，通常取決於外科醫師的選擇。此篇研究共有112名患者納入研究（每組56人），兩組患者在基本特徵和手術參數上相似。兩組間術前和術後的生化分析結果和國際前列腺症狀評分（IPSS）相似。除了全身疼痛總分在放尿管組較低外，泌尿系統症狀問卷（USSQ）的所有子域評分及視覺類比量表（VAS）評分在兩組間無顯著差異。沒有放置尿管組和放置尿管組併發症發生率分別為5.4%和8.9%。透過此研究結果顯示，導尿管的放置降低了術後全身疼痛總分，但對VAS疼痛評分無顯著影響。因此，在輸尿管鏡檢和放置雙J導管術後是否使用導導管，應根據外科醫師的偏好決定，同時考慮其對疼痛評分的潛在正面影響。 | |
| abstract |
Objectives: To evaluate the effects of inserting a Foley catheter after ureteroscopy (URS) and JJ stent placement on pain scores, voiding patterns, biochemical parameters and postoperative complications.
Patients and methods: A randomised clinical trial (1:1) with adult patients following unilateral URS + JJ stent placement was planned. In Group A, no Foley catheter was placed, in Group B, a Foley catheter was placed following URS + JJ stent placement. The primary objective was to evaluate effect of placing a Foley catheter on International Prostate Symptom Score (IPSS), Ureteric Stent Symptom Questionnaire (USSQ) score and postoperative biochemical parameters. The secondary objective was to evaluate postoperative complications. Results: A total of 112 patients were included (56/group). A ureteric access sheath was used in each patient. Patients had similar demographic and surgical parameters. The pre- and postoperative biochemical analyses including white blood cell count, C-reactive protein, procalcitonin and creatinine levels were similar between the two groups. The IPSS were similar between the two groups. All the subdomains of the USSQ were similar between two groups except Total Body Pain score, which was lower in Group B. The visual analogue scale scores were similar. Complications were all Clavien-Dindo Grade I and II, and the complication rate was 5.4% and 8.9% in Group A and B, respectively. Conclusion: Placing a Foley catheter following URS + JJ stent placement did not show significant effects on postoperative biochemical parameters and voiding symptoms. However, a Foley catheter lowered the Total Body Pain score on the USSQ without having significant effects on VAS scores. The practice of placing a Foley catheter following URS and JJ stent placement should be based on surgeon's preference keeping in mind the potential positive effect on pain scores. |
|
| 回覆發表 | 回覆討論主題內容 | 最後發表 |
| 目前尚無任何相關的回覆資料 | ||