Laube N, Bradenahl J, Meissner A, V Rappard J, Kleinen L, Müller S C
Abteilung für Experimentelle Urologie, Klinik und Poliklinik für Urologie, Universitätsklinikum, Sigmund-Freud-Strasse 25, 53105, Bonn.
Urologe A. 2006 Sep;45(9):1163-4, 1166-9. doi: 10.1007/s00120-006-1067-x.
Any material placed in the urinary tract is susceptible to the formation of encrustations of crystalline bacterial biofilms. These biofilms cause severe complications in some cases. The strategies used so far for reduction of these complications by surface modifications of the implant material failed to show the expected results.
In this study, we investigated amorphous carbon coatings (a-C:H) for their ability to effectively reduce or to repress the progressive formation of infection-enhancing crystalline biofilms as new functional surface coatings. In nine patients suffering for several years from stenting, a-C:H-coated ureteral stents were tested in treatment attempts. The current replacement intervals amounted to a mean of 77 days; the principle cause for early replacement was massive stent encrustations associated with symptomatic urinary tract infections.
In total, 20 coated ureteral stents were tested spanning indwelling times between 3 and 4 months. No stent-related complications occurred. In all cases extraordinarily facile handling, less pain during replacement, and markedly increased tolerance were observed. Symptomatic urinary tract infections were reduced by more than 50%. The stents remained virtually free of encrustations.
a-C:H coatings are a novel strategy leading to an enhancement of long-term applicability of ureteral stents and catheters and to improved patient comfort.
任何置于泌尿道的材料都易形成结晶性细菌生物膜结壳。这些生物膜在某些情况下会引发严重并发症。迄今为止，通过对植入材料进行表面改性来减少这些并发症的策略未能取得预期效果。
在本研究中，我们研究了非晶碳涂层（a-C:H）作为新型功能性表面涂层有效减少或抑制感染性结晶生物膜逐渐形成的能力。在9名患有多年支架置入术的患者中，尝试使用a-C:H涂层输尿管支架进行治疗。目前的更换间隔平均为77天；早期更换的主要原因是与有症状的尿路感染相关的大量支架结壳。
总共测试了20个涂层输尿管支架，留置时间为3至4个月。未发生与支架相关的并发症。在所有病例中，均观察到操作异常简便、更换时疼痛减轻以及耐受性明显提高。有症状的尿路感染减少了50%以上。支架几乎没有结壳。
a-C:H涂层是一种新策略，可提高输尿管支架和导管的长期适用性，并改善患者舒适度。
