(中英文)肾结石输尿管镜术后必读!Q&AforpatientsafterFURL/URL!
2020年02月23日 【健康号】 施飞     阅读 12765

做完输尿管镜碎石手术后,会出现哪些问题,如何应对?

-----上海交通大学附属瑞金医院古北分院【尿路结石专家科普大讲堂】系列第四讲

主讲人:施飞(上海交通大学附属瑞金医院古北分院泌尿外科主治医师 上海男科百名英才)


1.手术后导尿管什么时候可以拔掉

Time to remove the catheter after surgy?

一般术后次日即可拔导尿管,在拔管后可能有少许“血尿”和尿道不适,不必紧张,多饮水,勤排尿即可。

Generally, the catheter can be removed the next day after the operation. There may be a little "hematuria" and urethral discomfort after the extubation, but there is no need to be nervous, drink more water and urinate frequently can make these symptoms soon disappear.


2.术后什么时候可以吃饭

How long can you eat and drink after the operation?

术后6小时,肛门通气后可进食易消化饮食。

Six hours after the operation.


3.手术后为什么会在输尿管内留根管子

Why do you need to leave a tube in the ureter after surgery?

输尿管钬激光碎石手术后会放一根软的支架管(双J管),用于联通肾和膀胱。一头留在肾内,一头留在膀胱内,这样可以让肾内积水通畅地排出体外,更快解除肾积水保护肾脏功能、支撑输尿管防止输尿管狭窄,同时可以防止碎石排出过程中堵塞输尿管

After ureteral holmium laser lithotripsy, a soft stent (double J) is placed to connect the kidney to the bladder. One end is left in the kidney and the other in the bladder, which allows the hydronephrosis to pass out of the body unobstructed, which can remove the hydronephrosis more quickly, protect the kidney, support the ureter, prevent ureteral stricture, and prevent the blockage of the ureter during the passage of gravel.

上图:术后体内留置“双J管”示意图


4.什么时候来医院拔“双J管”

When will you come to the hospital to remove the stent?

一般两周至一个月左右,因人而异。入院后通过无痛膀胱镜拔除双J管。

[如果你血尿比较严重,疼痛刺激明显,也可酌情提前拔管;如无不适,因故耽误几日,也无大碍]

Generally two weeks to a month or so, vary from person to person.After admission, the double J tube was removed by painless cystoscope. [if your hematuria is serious and the pain is obvious, you can also extubate in advance; If you feel no discomfort, a few days' delay will  be ok.]



5.术后能不能上班、旅游、坐飞机……?

Can you go to work, take a plan or go on a trip?

术后,体内保留双J管,一般没有特别不适,大多数患友可以和双J管友好相处。但有少部分患友可能有不适,故建议可继续文职工作,勿剧烈运动,不推荐远游和长时间飞行,尽量多休息为主

After surgery, the double J tube is retained in the body, and there is usually no special discomfort. Most patients can get along well with the double J tube. However, a small number of patients may have discomfort, so it is recommended not to do strenuous exercise, travel far or take a long flight. It is recommended to take more rest.


6.为什么术后有尿频、尿急或尿痛

Why frequent, urgent or painful urination after surgery?

留置在体内的双J管末端刺激膀胱颈部或者尿路感染,可能会引起不同程度的尿频、尿急或者尿痛。症状的轻重因人而异。

The end of a stent in the body could irritate the neck of the bladder or  urinary tract infections, which can cause varying degrees of frequency, urgency, or painful urination. The severity of symptoms varies from person to person.


7.术后回家小便有血怎么办?

If hematuria occurs at home after operation, what should you do?

小便带血总是刺激患者神经的一件事儿,“医生,我小便全是血啊,怎么办?!”“医生出这么多血,会不会贫血?”“医生,快,快帮我止血啊,要住院挂水!”……

其实,术后血尿是双J管和膀胱、输尿管之间摩擦引起的微量出血,一般如洗肉水般淡红。

处理血尿勿惊慌:

多:多饮水,每日2000ML。

少:避免剧烈运动、跑步、弯腰和负重。

In fact, postoperative hematuria is a small amount of bleeding caused by the friction between the stent and Urinary tract mucous membrane, which is generally light red like meat washing water.
Do not panic when dealing with hematuria:
More: drink more water, 2000ML per day.
Less: avoid strenuous exercise: 
running, bending and weight bearing.


8.术后小便腰痛

Why do you have low back pain when you urinate after FURL/URL?

排尿时膀胱收缩,膀胱内压力上升,尿液通过双J管逆流入肾,可能引起不同程度的腰部疼痛不适。

处理:排尿时避免腹部太用力,不要憋尿

During urination, the bladder shrinks and the pressure inside the bladder rises, and the urine flows back into the kidney through the double J tube, which may cause different degrees of pain and discomfort in the lower back.
Treatment: when urinating, avoid abdominal too hard, do not hold urine.


9.术后有发热怎么办?

What should you do if you have a fever after the operation?

如果体温高于38.5℃等,立即复诊。低于此温度的低热,可以继续口服出院时带回的抗生素,并多饮水,多排尿,若症状加重或持续也需要即时复诊。

If the temperature is higher than 38.5℃, please go back to the hospital immediately. If the fever is lower than this temperature, you can continue to take the antibiotics when you took back from the hospital , and drink more water . If the symptoms get worse or persist, you also need to see the doctor immediately.


10.出院后第一次复查时间?

Time for the first review after discharge?

手术后需要口服5-7天抗菌素预防感染,出院后3天来院门诊复查尿常规血常规

After the operation, antibiotics should be taken orally for 5-7 days to prevent infection, and urine test and blood test should be reviewed in the outpatient clinic 3 days after discharge.


11.双J管拔除后还需要复诊吗?

When the stent is removed, do you need a second visit?

上图为“双J管”

Above is the double J tube.

在拔除双J管后一月左右,建议患者复查B超,了解肾积水恢复情况。

结石容易造成输尿管损伤、狭窄、滋生息肉甚至引起癌变,任何类型的尿路结石,都可能面临复发。建议您术后早期每3-6月门诊复查一次肾输尿管彩超。

About one month after the removal of the stent, it is recommended that the patient reexamine the ultrasound to understand the recovery of hydronephrosis.
Calculi are easy to cause ureteral injury, stricture, polyps and even cause cancer, any type of urinary calculi, may face recurrence. It is recommended that you reexamine the renal ureter color doppler ultrasound every 3-6 months in the early postoperative period.

2020/2/23日更新!

Updated 2020/2/23!


提示x

您已经顶过了!

确认
''
|
施飞
泌尿外科主治医师,上海交通大学医学院硕士研究生,擅长各类泌尿结石的微创手术、前列腺疾病和膀胱肿瘤的微创综合诊治,包括URL(输尿管镜治疗输尿管结石)、FURL(输尿管软镜治疗肾结石)、PCN(经皮肾镜治疗复杂巨大肾结石、鹿角形结石,1.6mm超微穿刺通道可视肾镜联合钬激光碎石)、一次性软镜治疗肾及输尿管上段结石、尤其擅长飞行员微小肾结石输尿管软镜下取石、泌尿结石综合防治。
去Ta主页
Ta最近的文章

热门文章

请选择举报原因
垃圾广告信息
色情低俗内容
违规有害信息
侵犯隐私、虚假谣传