Shehab M, El Helali A, Abdelkhalek M, Abdelshafy M, Mourad M, El Helaly H, Zikry M
Department of Urology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Urol Ann. 2013 Jul;5(3):148-51. doi: 10.4103/0974-7796.115731.
The aim of this study is to evaluate the role of ureteric stents in relieving obstruction and improvement of kidney function in patients with obstructive uropathy.
This study involved 138 patients with obstructive uropathy with age ranged from 2 months to 73 years. Patients classified into two groups: Group (I): Includes 57 patients (41.3%), ureteric stents fixed to them; and Group (II): Includes 81 patients (58.6%) managed by other treatment modalities. All patients underwent clinical assessment, Laboratory and radiologic investigations: At presentation and postoperative. These included: Complete urine analysis, urine culture and sensitivity, serum creatinine, serum urea nitrogen, serum uric acid, serum sodium (Na), serum potassium (K), Fasting blood glucose level and blood picture and plain X-ray (KUB), abdominal ultrasonography (US), diuretic renography and retrograde pyelography.
Renal glomerular filtration rate (GFR) was used as an indicator for improvement of renal function after fixation of ureteric stent. In group I: 56 (71.8%) kidneys showed significant recovery compared to 61 kidneys (66.3%). In group II, there is statistically significant relation between renal perfusion and renal recovery (P < 0.004), statistically significant relation between parenchymal thickness and recovery in both groups (P < 0.0002), statistically significant relation between degree of corticomedullary differentiation and recovery (P < 0.0003) and statistically significant relationship between hemoglobin levels at presentation and the recoverability (P < 0.002).
The predictors of renal recoverability revealed that ureteral stents alone can help in regaining renal function and significant improvement of clinical condition in patients with obstructive uropathy.
本研究旨在评估输尿管支架在缓解梗阻性肾病患者梗阻及改善肾功能方面的作用。
本研究纳入了138例梗阻性肾病患者,年龄范围为2个月至73岁。患者分为两组:第一组(I组):包括57例患者(41.3%),为置入输尿管支架的患者;第二组(II组):包括81例患者(58.6%),采用其他治疗方式。所有患者在就诊时及术后均接受了临床评估、实验室及影像学检查:这些检查包括:尿常规、尿培养及药敏、血清肌酐、血清尿素氮、血清尿酸、血清钠(Na)、血清钾(K)、空腹血糖水平及血常规,以及腹部平片(KUB)、腹部超声(US)、利尿肾图及逆行肾盂造影。
肾小球滤过率(GFR)被用作输尿管支架置入后肾功能改善的指标。在I组中:56个肾脏(71.8%)显示出显著恢复,而II组为61个肾脏(66.3%)。在II组中,肾灌注与肾恢复之间存在统计学显著相关性(P < 0.004),两组实质厚度与恢复之间存在统计学显著相关性(P < 0.0002),皮质髓质分化程度与恢复之间存在统计学显著相关性(P < 0.0003),就诊时血红蛋白水平与恢复能力之间存在统计学显著相关性(P < 0.002)。
肾脏恢复能力的预测指标显示,单独使用输尿管支架有助于梗阻性肾病患者恢复肾功能并显著改善临床状况。