Richter S, Ringel A, Shalev M, Nissenkorn I
Department of Urology, Sapir Medical Center, Kfar Sava, Sackler Faculty of Medicine, University of Tel Aviv, Israel.
BJU Int. 2000 Mar;85(4):408-11. doi: 10.1046/j.1464-410x.1998.00543.x-i1.
To review the morbidity and complications of ureteric stent insertion and to evaluate specifically the effect of an indwelling ureteric stent on the changes in hydronephrosis after stenting.
In a prospective study, 110 renal units with a stent in place were evaluated in 90 patients. Of the 110 stents, 52 were left in place for 3 months, 23 for 6, 11 for 9, 19 for 12 and five (forgotten stents) for 13-30 months. The patients were followed using plain abdominal X-ray at 1 and 30 days after stenting. They were further followed using ultrasonography and plain films every 3 months until the scheduled date for stent removal or the appearance of complications.
Thirty-four patients had fever and bacteriuria after stent insertion. Of the 110 stents, 11 (10%) fragmented and nine (8%) migrated. Seventeen patients complained of flank pain on voiding. In 21 renal units (19%) there was no change in the severity of hydronephrosis, whereas in six (5.5%) hydronephrosis developed or worsened after stenting.
Although ureteric stenting is undoubtedly an important procedure to relieve ureteric obstruction, the indications for stent insertion should be considered carefully in every patient. The close follow-up of stented patients is valuable for the early detection of morbidity or complications and in such cases the stent should be removed or exchanged as soon as possible.
回顾输尿管支架置入的发病率及并发症，并特别评估留置输尿管支架对支架置入后肾积水变化的影响。
在一项前瞻性研究中，对90例患者体内置入的110个肾单位支架进行了评估。在这110个支架中，52个留置3个月，23个留置6个月，11个留置9个月，19个留置12个月，5个（遗忘支架）留置13 - 30个月。在支架置入后1天及30天通过腹部平片对患者进行随访。之后每3个月通过超声检查和平片进一步随访，直至预定的支架取出日期或出现并发症。
34例患者在支架置入后出现发热和菌尿。在110个支架中，11个（10%）断裂，9个（8%）移位。17例患者排尿时诉胁腹疼痛。21个肾单位（19%）肾积水严重程度无变化，而6个（5.5%）肾积水在支架置入后出现或加重。
尽管输尿管支架置入无疑是缓解输尿管梗阻的重要手段，但对每例患者都应仔细考虑支架置入的适应证。对置入支架的患者进行密切随访对于早期发现发病情况或并发症很有价值，在这种情况下应尽快取出或更换支架。
