(1) Patvirtinimo, kad dvigubo J vamzdelio apatinis galas operacijos metu yra šlapimo pūslėje, metodas:
① After the catheter is placed, there is resistance to gently pulling the catheter, and it retracts into the ureter quickly after releasing it.
②The catheter enters the back hole of the bladder and urine flows out.
③Inject methylene blue into the bladder, squeeze the lower abdomen, and blue liquid flows out from the side hole.
④ Intraoperative X-ray or cystoscopy confirmed.
(2) Siekiant išvengti komplikacijų atsiradimo, taip pat reikėtų atkreipti dėmesį į:
①Choose different types and good quality double-J tubes according to different patients, and estimate the position and length of the upper or lower double-J tubes according to the position of the stones on the intravenous pyelogram before surgery.
② The No. 1 silk thread is sewn at the end of the double J tube. After the upward movement, the silk thread can be clamped by the cystoscope and the double J tube can be taken out, so as to avoid the pain and economic loss caused by the operation, ureteroscopy and other methods to the patient.
③ X-ray or B-ultrasound to understand the position of the double J tube, and adjust the position of the double J tube through the cystoscope if necessary.
④ Long-term placement of double-J tubes should be replaced regularly to avoid the formation of stones. Ask the patient to drink plenty of fluids to reduce urinary salt deposition.
Apibendrinant galima pasakyti, kad kuo ilgesnis dvigubo J kateterio buvimo laikas, tuo didesnis komplikacijų dažnis, todėl jį reikia laiku pašalinti. Paprastai įtaisytas vamzdelis yra praėjus 4–6 savaitėms po operacijos. Tiems, kuriems tikrai reikia ilgalaikio-vidaus vamzdžio, jį reikėtų keisti kas 2–3 mėnesius. Be to, pooperacinis stebėjimas taip pat labai svarbus, ne laiku, komplikacijos ar komplikuoti akmenys gali apsunkinti kateterio pašalinimą, o tai ne tik padidina fizinę ir ekonominę paciento naudą.
Therefore, a strict follow-up system must be established: the operation records should be written with a built-in double-J tube; during the postoperative rounds, the patients and their families should be explained to the patients and their families that there are built-in double-J tubes, explaining the function and precautions ; The doctor's order in the discharge medical record should indicate the time of the follow-up visit and take the tube, and ask to drink more water.
