Allium覆膜输尿管支架长期留置治疗输尿管狭窄的疗效分析  

Clinical evaluation of long-term indwelling of Allium ureteral stent in the treatment of ureteral stricture

作　　者：李帅 赵江 朱景振 伍应兵 张远宁 孙碧韶 易善红 LI Shuai;ZHAO Jiang;ZHU Jingzhen;WU Yingbing;ZHANG Yuanning;SUN Bishao;YI Shanhong(Department of Urology,The Second Affiliated Hospital of the Army Medical University,Chongqing 400037,China)

机构地区：[1]陆军军医大学第二附属医院泌尿外科,重庆400037

出　　处：《现代泌尿外科杂志》2023年第11期942-946,951,共6页Journal of Modern Urology

摘　　要：目的分析采用Allium覆膜输尿管支架长期留置治疗输尿管狭窄的安全性及有效性。方法回顾性分析2020年8月—2022年12月在陆军军医大学第二附属医院因输尿管狭窄行内镜下Allium覆膜输尿管支架置入术治疗的患者的临床资料,记录患者手术情况及术后随访期内的不良反应事件发生情况,对患者术前和术后1、3、6、12个月的血肌酐、血尿素氮、肾小球滤过率(GFR)、超声下肾盂宽度等数据进行比较。结果共纳入52例患者,其输尿管狭窄长度1.1(0.7~2.0)cm。所有患者均手术顺利,手术时间82.5(70~114)min,术中出血量20(10~20)mL;术后住院天数1(1~2)d;术后随访时间(13.2±7.8)个月,其中有14例患者发生支架移位,5例患者出现结石阻塞支架管,7例患者出现偶尔活动后血尿,9例患者出现间歇性腰腹部疼痛,1例患者出现反复泌尿系感染;术后1、3、6、12个月的血肌酐、血尿素氮、超声下肾盂宽度较术前均明显降低,GFR均明显升高。结论Allium覆膜输尿管支架长期留置治疗输尿管狭窄疗效可观,但支架移位发生率高,应引起重视。Objective To evaluate the safety and efficacy of long-term indwelling of Allium ureteral stent in the treatment of ureteral stricture.Methods The clinical data of patients who underwent endoscopic Allium ureteral stent implantation for ureteral stricture in our hospital during Aug.2020 and Dec.2022 were retrospectively analyzed,and the surgical conditions and adverse events were recorded.The data of serum creatinine,blood urea nitrogen,glomerular filtration rate(GFR)and renal pelvis width under ultrasound were compared before surgery and 1,3,6 and 12 months after surgery.Results A total of 52 patients with ureteral stricture of 1.1(0.7,2.0)cm were included.All operations were successful.The operation time was 82.5(70,114)min,intraoperative blood loss 20(10,20)mL,and postoperative hospitalization stay 1(1,2)day.During the follow-up of(13.2±7.8)months,14 patients had stent displacement,5 had stone obstruction of stent tubes,7 had occasional hematuria after movement,9 had intermittent lumbar and abdominal pain,and 1 had recurrent urinary tract infection.The serum creatinine,blood urea nitrogen and renal pelvis width of 1 month,3,6 and 12 months after surgery were significantly decreased,while GFR was significantly increased.Conclusion Long-term indwelling of Allium ureteral stent is effective in the treatment of ureteral stricture,but the high incidence of stent displacement should arouse attention.

关 键 词：Allium覆膜输尿管支架 长期留置 输尿管狭窄 安全性 有效性 

分 类 号：R693.2[医药卫生—泌尿科学]