尿道金属覆膜支架在男性球膜部尿道狭窄中的初步应用  

Allium Ureteral Stent in Male Bulbar Urethral Stricture

作　　者：王梦珍 余月[1] 周晓晨[1] 习海波[1] 傅斌[1] 陈庆科[1] WANG Meng-zhen;YU Yue;ZHOU Xiao-chen;XI Hai-bo;FU Bin;CHEN Qing-ke(Department of Urology,the First Affiliated Hospital of Nanchang University,Nanchang 330006,China)

机构地区：[1]南昌大学第一附属医院泌尿外科,南昌330006

出　　处：《南昌大学学报（医学版）》2024年第4期65-69,共5页Journal of Nanchang University：Medical Sciences

基　　金：江西省科技厅应用培育计划(20212BAG70001)。

摘　　要：目的探讨尿道金属覆膜(Allium)支架用于治疗男性球膜部尿道狭窄的效果。方法回顾性分析2021年6月至2023年12月在南昌大学第一附属医院就诊并使用Allium支架治疗的男性尿道狭窄患者的临床资料,共计14例。均因外伤引起,年龄16~66(44.5±15.3)岁,狭窄部位均在尿道球膜部,狭窄或闭锁长度为0.8~2.5 cm(平均1.4 cm),术前最大尿流率为1.5~7.8 mL·s^(-1)。结果14例患者均Ⅰ期顺利植入长为6 cm的Allium支架,术中使用缝线将支架与尿道固定,术后恢复正常排尿,最大尿流率提升至15.4 mL·s^(-1),手术时间(43.5±10.8)min,术中出血量(25.4±10.6)mL,术后2~5 d出院。出院后随访3~29个月(平均12.4个月),其间3例患者(占前期患者60%,3/5)由于使用可吸收缝线固定支架发生移位,2例(占后期患者22%,2/9)使用不可吸收缝线固定后发生移位;5例患者发生支架感染和支架内结石;1例患者在术后8个月因尿道支架反复堵塞感染选择拔出支架后仍排尿困难,最终行尿道成形术。所有患者随访至2023年12月均排尿正常、无尿失禁发生且未出现严重并发症。结论尽管有并发感染、生长结石,支架移位的风险,短期随访(平均12.4个月)结果提示Allium支架用于治疗男性球膜部尿道狭窄仍然是一种安全有效的选择。临床上注意根据患者基础情况和预期效果,谨慎地选择Allium支架手术的适应证。Objective To investigate the safety and efficacy of Allium ureteral stent in the treatment of male bulbar urethral stricture.Methods A total of 14 male patients with urethral stricture who received Allium ureteral stents from June 2021 to December 2023 at the First Affiliated Hospital of Nanchang University were selected as the study subjects,and their clinical data were retrospectively analyzed.All the patients,aged 16 to 66(44.5±15.3)years old,were caused by trauma,with the site of stricture in the bulbar membrane of the urethra,the length of the stricture or atresia ranging from 0.8 to 2.5 cm(mean,1.4 cm),and the maximal preoperative urinary flow rate ranging from 1.5 to 7.8 mL·s^(-1).Results All 14 patients were successfully implanted with a 6 cm Allium urethral stent in StageⅠ;the stent was fixed to the urethra using sutures during the operation;normal urination was resumed after the operation,with an elevated maximal urinary flow rate of 15.4 mL·s^(-1),an operative time of(43.5±10.8)min,and an intraoperative bleeding rate of(25.4±10.6)mL;they were discharged from hospital 2 to 5 d after the operation.The postoperative follow-ups ranged from 3 to 29 months(mean 12.4 months);during the follow-ups,3 patients(60%of patients in the early phase,3/5)experienced dislocation due to fixation of the stent with absorbable sutures;2(22%of patients in the late phase,2/9)experienced dislocation after fixation with non-absorbable sutures;5 patients experienced stent infection and in-stent calculi;1 patient had difficulty urinating even after opting for stent removal due to recurrent blockage of the urethral stent for infection at 8 months postoperatively,and ultimately underwent urethroplasty.All patients were followed up until December 2023 with normal urination,no urinary incontinence and no serious complications.Conclusion Despite the risks of concomitant infections,growing stones,and stent migration,the results of short-term follow-ups(mean 12.4 months)suggest that the Allium ureteral stent may remain a safe and

关 键 词：尿道狭窄 球膜部 尿道金属覆膜支架 适应证 短期随访 

分 类 号：R699.6[医药卫生—泌尿科学]