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被遗忘的输尿管双J支架及其预防:输尿管支架登记册价值的前瞻性审计

The forgotten ureteric JJ stent and its prevention: a prospective audit of the value of a ureteric stent logbook.

作者信息

Thomas A Z, Casey R G, Grainger R, McDermott T, Flynn R, Thornhill J A

机构信息

Department of Urology, The Adelaide & Meath Hospital Incorporating the National Children's Hospital, Tallaght, Dublin 24, Republic of Ireland.

出版信息

Ir J Med Sci. 2007 Jul-Sep;176(2):117-9. doi: 10.1007/s11845-007-0043-9. Epub 2007 May 22.

DOI:10.1007/s11845-007-0043-9
PMID:17516130
Abstract

BACKGROUND

Temporary ureteric stent insertion is an integral part of modern endo-urological practice. Delayed stent removal or forgotten stents are associated with increased patient morbidity and complications which are often difficult to manage.

METHODS AND RESULTS

We prospectively audited our ureteric stent insertion and removal logbook system to determine the value and effectiveness of our stent follow-up. Over a 1-year period, 210 ureteric stents were inserted in our urological unit. Of these, 47 (22.4%) patients were unaccounted as having their stents removed within the stent logbooks. One patient was lost to follow-up and re-presented with stent encrustation 10 months later.

CONCLUSIONS

Our results in this audit suggest that our system of ureteric stent follow-up is not effective. We have now introduced a new system that we feel is a safer and a satisfactory alternative to the stent logbooks. This includes a patient education leaflet and removal date scheduling prior to discharge from hospital.

摘要

背景

临时输尿管支架置入是现代腔内泌尿外科手术的一个重要组成部分。支架延迟取出或遗忘取出与患者发病率增加及并发症相关,而这些并发症往往难以处理。

方法与结果

我们对输尿管支架置入和取出登记本系统进行了前瞻性审核,以确定我们的支架随访的价值和有效性。在1年的时间里,我们泌尿外科共置入了210根输尿管支架。其中,47例(22.4%)患者在支架登记本中未记录支架已取出。1例患者失访,10个月后再次就诊时出现支架结痂。

结论

本次审核结果表明,我们的输尿管支架随访系统无效。我们现已引入一种新系统,我们认为该系统比支架登记本更安全、更令人满意。这包括一份患者教育传单以及在出院前安排取出日期。

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本文引用的文献

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Clinical features determining the fate of a long-term, indwelling, forgotten double J stents.决定长期留置、被遗忘的双J管转归的临床特征
Urol Res. 2004 Dec;32(6):416-20. doi: 10.1007/s00240-004-0442-6. Epub 2004 Oct 14.
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Patient empowerment in the United States: a critical commentary.美国的患者赋权:一篇批判性评论。
Health Expect. 1999 May;2(2):82-92. doi: 10.1046/j.1369-6513.1999.00048.x.
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The indwelling ureteric stent: a 'friendly' procedure with unfriendly high morbidity.留置输尿管支架:一种“友好”的操作,却伴有不友好的高发病率。
基于智能手机的支架跟踪应用程序预防被遗忘的输尿管双 J 支架:一项前瞻性研究。
Int Braz J Urol. 2019 Mar-Apr;45(2):376-383. doi: 10.1590/S1677-5538.IBJU.2018.0707.
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Development and evaluation of a centralised computerised registry for ureteric stents: completing the audit cycle.输尿管支架集中式计算机注册系统的开发与评估:完善审计周期
Ir J Med Sci. 2017 Nov;186(4):1057-1060. doi: 10.1007/s11845-016-1534-3. Epub 2017 Feb 2.
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Treatment of forgotten ureteral stents: how much does it really cost? A cost-effectiveness study in 27 patients.遗忘输尿管支架的治疗:实际花费多少?一项针对27例患者的成本效益研究。
Urol Res. 2012 Aug;40(4):317-25. doi: 10.1007/s00240-011-0409-3. Epub 2011 Aug 11.
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A solution for medical and legal problems arising from forgotten ureteral stents: initial results from a reminder short message service (SMS).解决因遗忘输尿管支架引发的医学和法律问题的方案:短信提醒服务(SMS)的初步结果
Urol Res. 2012 Jun;40(3):253-8. doi: 10.1007/s00240-011-0404-8. Epub 2011 Jul 27.
BJU Int. 2000 Mar;85(4):408-11. doi: 10.1046/j.1464-410x.1998.00543.x-i1.
4
A computerized ureteric stent retrieval system.一种计算机化的输尿管支架取出系统。
Br J Urol. 1996 Jan;77(1):147-8. doi: 10.1046/j.1464-410x.1996.87626.x.
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The forgotten indwelling ureteral stent: a urological dilemma.被遗忘的留置输尿管支架:泌尿外科的困境
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Experience with new double J ureteral catheter stent.新型双J输尿管导管支架的使用经验
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