Sakamoto Hiromasa, Matsuda Ayumu, Kanno Toru, Yamada Hitoshi
The Department of Urology, Ijinkai Takeda General Hospital.
Hinyokika Kiyo. 2012 Jun;58(6):269-72.
An indwelling ureteral stent is commonly used for relief of ureteral obstruction. However, few reports have documented the frequency of febrile urinary tract infection and changes in renal function in patients with long-term ureteral stent placement. Here we report our experience with patients who had undergone long-term placement of ureteral stents. Between January 2005 and March 2011, we performed exchange of ureteral stents in 25 patients for more than one year. The mean serum creatinine level at the baseline, after stent placement, and 1 year later was 2.10, 1.24, and 1.39 mg/dl, respectively. In 14 of the patients, 39 episodes of febrile urinary tract infection occurred. Among a total of 1,055 stent exchanges, 39 episodes (3.7%) of stent encrustation occurred. Two patients in whom stents had been forgotten suffered septic shock. The serum creatinine level following a long placement period did not change significantly, and of the patients whose hydronephrosis remained after stent placement, the risk of febrile urinary tract infection rises. Our results suggest that ureteral stents could be indwelt for a fairly long period of time without major complications as long as they were carefully followed up and regularly exchanged.
留置输尿管支架常用于缓解输尿管梗阻。然而,很少有报告记录长期放置输尿管支架患者的发热性尿路感染频率及肾功能变化。在此,我们报告长期放置输尿管支架患者的相关经验。2005年1月至2011年3月期间,我们对25例患者进行了超过一年的输尿管支架更换。基线时、支架置入后及1年后的平均血清肌酐水平分别为2.10、1.24和1.39mg/dl。14例患者发生了39次发热性尿路感染。在总共1055次支架更换中,发生了39次(3.7%)支架结壳。2例遗忘取出支架的患者发生感染性休克。长期放置后血清肌酐水平无显著变化,支架置入后仍有肾积水的患者,发热性尿路感染风险增加。我们的结果表明,只要仔细随访并定期更换,输尿管支架可以较长时间留置而无重大并发症。