多功能支架与传统内支架在膀胱全切输尿管皮肤造口病人中应用  

Application of multifunctional and traditional internal stents in patients with total ureteral resection cutaneous stomy

作　　者：罗华荣[1] 顾嬿[2] 黄盛松[1] 徐琼峰[1] 徐成党 王天如[1] LUO Huarong;GU Yan;HUANG Shengsong;XU Qiongfeng;XU Chengdang;WANG Tianru(Urology Department,Tongji University Affiliated Tongji Hospital,Shanghai 200065,China;不详)

机构地区：[1]同济大学附属同济医院泌尿外科,上海200065 [2]同济大学附属同济医院普通外科,上海200065

出　　处：《临床外科杂志》2024年第11期1211-1214,共4页Journal of Clinical Surgery

基　　金：上海市科技计划项目(21ZR1458300)。

摘　　要：目的对比多功能输尿管造口支架和传统输尿管造口内支架在膀胱全切输尿管皮肤造口病人中应用。方法前瞻性选取2019年3月~2023年3月本院收治的膀胱癌并择期行膀胱根治性切除加尿流改道术病人102例,按随机数排秩法将病人分为研究组(51例)与对照组(51例),对照组予以传统单J输尿管造口内支架引流装置,研究组予以多功能输尿管造口支架引流装置。比较两组社会心理适应量表-23(OAI-23)评分、估算肾小球滤过率(eGFR)、近期并发症发生情况、远期并发症发生情况、生活质量评分采用膀胱癌特异性量表(FACT-BL评分)的差异。结果研究组术后1个月、3个月、6个月OAI评分分别为(49.33±4.07)分、(57.29±3.90)分、(68.25±3.76)分;对照组分别为(44.25±4.61)分、(52.31±4.58)分、(59.06±4.37)分,与术前比较均升高,且研究组均高于对照组,差异有统计学意义(P<0.05)。研究组术后3个月、术后6个月eGFR分别为(86.07±4.07)ml/min、(88.01±3.01)ml/min;对照组分别为(83.09±3.06)ml/min、(85.06±5.09)ml/min,与术前比较均升高,且研究组高于对照组,差异有统计学意义(P<0.05)。研究组近期并发症总发生率低于对照组(7.84%vs.23.53%,P<0.05)。研究组远期并发症总发生率低于对照组(43.14%VS 78.43%,P<0.05)。研究组术后6个月FACT-BL总分为(129.59±5.74)分;对照组为(114.10±10.37)分,与术前比较升高,且研究组高于对照组,差异有统计学意义(P<0.05)。结论多功能输尿管造口支架应用于膀胱全切输尿管皮肤造口病人可有效改善造口适应性,促进肾功能恢复,减少近期和远期并发症发生风险,提高病人生活质量。Objective To compare the application of multifunctional ureterostomy stent and traditional ureterostomy internal stent in patients with total ureterostomy.Methods Prospectively,102 patients with bladder cancer and undergoing elective radical cystectomy with urinary diversion admitted to our hospital from March 2019 to March 2023 were selected for the study.According to the random number rank method,the patients were divided into the study group(51 cases)and the control group(51 cases).The control group was given a traditional single-J ureteral stomy stent drainage device,and the research group was given a multifunctional ureteral stomy stent drainage device.The differences of OAI score,renal function index(eGFR),recent complications,long-term complications and quality of life(FACT-BL score)were compared between the two groups.Results OAI scores 1 month,3 months and 6 months after surgery(study group:49.33±4.07,57.29±3.90,68.25±3.76;control group:44.25±4.61,52.31±4.58,59.06±4.37)and before surgery(study group:32.71±4.32;control group:33.18±4.74)compared with higher levels(P<0.05),but the study group was higher than the control group(P<0.05).Repeated measurement ANOVA results showed that eGFR at 3 months and 6 months after surgery(study group:86.07±4.07,88.01±3.01;control group:83.09±3.06,85.06±5.09)and before surgery(study group:82.05±6.04;control group:81.03±5.06)compared with higher levels(P<0.05),but the study group was higher than the control group(P<0.05).The total rate of recent complications in the study group was lower than that in the control group(7.84%VS 23.53%,P<0.05).The total incidence of long-term complications in the study group was lower than that in the control group(43.14%VS 78.43%,P<0.05).Emotional status score,physical status score,functional status score,social and family status score,BSS score,FACT-BL total score of the two groups 6 months after surgery(study group:20.25±2.36,24.92±1.87,25.65±1.11,26.02±1.14,32.75±1.76,129.59±5.74;Control group:18.65±3.10,20.18±3.02,23.

关 键 词：膀胱根治性切除术 输尿管皮肤造口 多功能输尿管造口支架 传统输尿管造口内支架 术后并发症 肾功能 

分 类 号：R737.14[医药卫生—肿瘤]