Allium覆膜金属支架治疗腹膜后肿瘤所致输尿管梗阻的并发症、肾功能变化分析  

Incidence of complications and changes in renal function of Allium covered metal stent in the treatment of ureteral obstruction caused by retroperitoneal tumor

作　　者：李善彦 屈卫星 安旭方 薛长辉 张柱德 Li Shanyan;Qu Weixing;An Xufang;Xue Changhui;Zhang Zhude(Department of Urology,the Second People's Hospital of Xining City,Xining 810000,China)

机构地区：[1]西宁市第二人民医院泌尿外科,西宁810000

出　　处：《国际泌尿系统杂志》2022年第6期1015-1019,共5页International Journal of Urology and Nephrology

摘　　要：目的探讨Allium覆膜金属支架治疗腹膜后肿瘤所致输尿管梗阻的并发症发生率及肾功能情况。方法回顾性选取本院2018年6月至2021年8月收治的41例腹膜后肿瘤所致输尿管梗阻患者为研究对象。所有患者均在输尿管镜下或肾镜下行Allium覆膜金属支架治疗,收集患者的临床资料,观察并记录患者的治疗效果,包括治疗前后的输尿管支架症状问卷(USSQ)评分、治疗后的并发症发生情况以及治疗前(T0)、治疗后1周(T1)、治疗后2周(T2)、治疗后2个月(T3)、治疗后6个月(T4)的肾功能情况。结果41例患者中顺行置入支架者27例,逆行置入支架者14例,两种置入方式的术中出血量及手术时间等情况比较,差异均无统计学意义(均P>0.05);所有患者治疗后的USSQ评分表中各项评分均较治疗前降低(均P<0.001);支架置入失败率为12.20%(5/41);支架置入成功患者的术后总并发症发生率为8.33%(3/36)。T4随访中发生6例支架移位,5例结石生长;与T0比较,T1~T4所有患者治疗后的尿素氮、血肌酐水平逐渐降低且均明显低于T0(均P<0.05),肾小球滤过率逐渐升高且均高于T0(均P<0.05)。结论Allium覆膜金属支架治疗腹膜后肿瘤所致输尿管梗阻的安全性较高、术后疗效确切,能够降低患者术后的相关并发症发生率,改善肾功能,值得推广使用。Objective To investigate the incidence of complications and changes in renal function of Allium covered metal stent in the treatment of ureteral obstruction caused by retroperitoneal tumor.Methods Forty-one patients with ureteral obstruction caused by retroperitoneal tumor admitted to our hospital from June 2018 to August 2021 were retrospectively selected and treated with Allium covered metal stent under ureteroscope or nephroscope.Clinically-relevant data were collected.The therapeutic effect,ureteric stent symptom questionnaire(USSQ)before and after treatment,complications after treatment and changes in renal function before treatment(TO),1 week after treatment(T1),2 weeks after treatment(T2),2 months after treatment(T3)and 6 months after treatment(T4)were observed and recorded.ResultsAmong the 41 patients,27 patients underwent antegrade placement,and 14 patients underwent retrograde placement.There was no significant difference in intraoperative blood loss and operation time between the two implantation methods(all P>0.05).Compared with those before treatment,all scores in USSQ score table decreased in all patients after treatment(all P<0.001).The implantation failure rate was 12.20%(5/41).The total postoperative complication rate of successful implantation patients was 8.33%(3/36).During follow-up after T4,stent displacement occurred in 6 cases and stone growth occurred in 5 cases.Compared with TO,urea nitrogen and serum creatinine levels gradually decreased and were significantly lower in all patients from T1 to T4 after treatment than TO(all P<0.05),and glomerular filtration rate gradually increased and was significantly higher than TO(all P<0.05).Conclusions Allium covered metal stent in the treatment of ureteral obstruction caused by retroperitoneal tumor is safe and effective.It can significantly reduce the incidence of postoperative complications and improve renal function.It is worthy of being widely popularized.

关 键 词：腹膜后肿瘤 覆膜支架 输尿管梗阻 

分 类 号：R735.4[医药卫生—肿瘤] R699.4[医药卫生—临床医学]