良性输尿管狭窄腔内手术治疗后置入海马型输尿管支架的临床效果研究  

Clinical effects of hippocampal ureteral stent implantation after endoluminal surgery for benign ureteral strictures

作　　者：欧阳洁 张国庆[1] 印胡滨 朱鑫[1] 苟欣[1] 邓远忠[1] OUYANG Jie;ZHANG Guoqing;YIN Hubin;ZHU Xin;GOU Xin;DENG Yuanzhong(Department of Urology,First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China)

机构地区：[1]重庆医科大学附属第一医院泌尿外科,重庆400016

出　　处：《重庆医学》2023年第15期2295-2300,共6页Chongqing medicine

基　　金：重庆市自然科学基金一般项目(CSTB2022BSXM-JCX0037)。

摘　　要：目的研究良性输尿管狭窄腔内手术治疗后置入海马型输尿管支架的临床效果。方法选取2020年1月至2021年12月该院行良性输尿管狭窄腔内手术治疗患者60例作为研究对象。根据置入输尿管支架类型分为3组,采用单根标准形状输尿管支架者纳入A组,采用海马型输尿管支架者纳入B组,采用多根标准形状输尿管支架者纳入C组,每组各20例。同时收集3组患者一般资料(包括年龄、性别、狭窄侧别、狭窄部位、狭窄长度、狭窄程度、肾积水程度、术前肌酐水平等)及留置输尿管支架期间不良反应情况(包括腰痛症状、肉眼血尿症状、膀胱刺激症状及支架结石壳形成等),并对所收集的资料进行系统性分析讨论。结果60例患者均顺利完成手术,其中男性36例,女性24例;轻度狭窄36例,重度狭窄24例;轻度积水30例,中度积水20例,重度积水10例。3组患者一般资料和狭窄特征比较差异无统计学意义(P>0.05)。3组患者治疗有效率比较差异无统计学意义(P=0.174),但A组的狭窄复发率(55.0%)明显高于B组(40.0%)和C组(25.0%)。A、B组腰痛视觉模拟量表(VAS)评分,输尿管支架症状问卷(USSQ)血尿评分、USSQ膀胱刺激症状评分均低于C组,生活质量评分高于C组,差异均有统计学意义(P<0.05)。结论良性输尿管狭窄腔内手术后置入海马型输尿管支架的治疗费用相对较少,能有效促进输尿管恢复,明显缓解留置输尿管支架期间不良反应症状。Objective To investigate the clinical impact of implanting ureteral stents in the hippocampus following endoluminal surgery for benign ureteral strictures.Methods From January 2020 to December 2021,we selected 60 patients who underwent endovascular surgery for benign ureteral strictures at our hospital as the subjects of our research.According to the type of ureteral stent implantation,the patients were divided into three groups.Those who used a single standard-shaped ureteral stent were included in group A,those who used hippocampus-shaped ureteral stents were included in group B,and those who used multiple standard-shaped ureteral stents were included in group C,with 20 cases in each group.Simultaneously,the researchers collected general data on the patients in the three groups,which included information such as age,gender,side of stenosis,location of stenosis,length of stenosis,degree of stenosis,degree of hydronephrosis,and preoperative creatinine level.Additionally,the researchers collected data on the adverse reactions experienced by the patients during the indwelling ureteral stent,such as symptoms of low back pain,gross hematuria,bladder irritation,and stent stone shell formation.The collected data was then systematically analyzed and discussed.Results All 60 patients successfully completed the operation,including 36 males and 24 females.There were 36 cases of mild stenosis and 24 cases of severe stenosis.There were 30 cases of mild water accumulation,20 cases of moderate water accumulation,and 10 cases of severe water accumulation.There was no significant difference in the general information and stenosis characteristics among the three groups(P>0.05).There was no significant difference in the effective rate among the three groups(P=0.174),but the recurrence rate of stenosis in group A(55.0%)was significantly higher than that in group B(40.0%)and group C(25.0%).The VAS score for low back pain,USSQ hematuria score,and USSQ bladder irritation score were all lower in group A and B compared to group C.Additi

关 键 词：良性输尿管狭窄 腔内手术治疗 输尿管支架 预后 海马型 

分 类 号：R693[医药卫生—泌尿科学]