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用于治疗输尿管梗阻的猫用双猪尾输尿管支架:26只猫的短期和长期随访

Feline double pigtail ureteric stents for management of ureteric obstruction: short- and long-term follow-up of 26 cats.

作者信息

Kulendra Nicola Jayne, Syme Harriet, Benigni Livia, Halfacree Zoe

机构信息

Royal Veterinary College, Hatfield, UK

Royal Veterinary College, Hatfield, UK.

出版信息

J Feline Med Surg. 2014 Dec;16(12):985-91. doi: 10.1177/1098612X14531763. Epub 2014 Apr 29.

Abstract

The objective of this study was to determine the outcome of cats with ureteric obstruction managed with double pigtail ureteric stents and to document the incidence of lower urinary tract signs at long-term follow-up. Data were obtained retrospectively from the medical records (2009-2012) of 26 cats that underwent ureteric stent placement. Owners were contacted for follow-up, and a quality of life questionnaire completed. Survival to discharge after stent placement was 85% (22/26). Prevalence of postoperative uroabdomen necessitating further surgery was 15% (4/26). Stents were replaced 4-28 months after the initial surgery in four cats because of migration, fracture, encrustation causing luminal obstruction or sterile cystitis, respectively. Nine cats were alive at follow-up, which was 3-28 months after the original surgery. Nine cats had azotaemic chronic kidney disease and nine had signs related to sterile cystitis; three of these cats were euthanased as a result of the severity of the signs. Preoperative serum creatinine of the survivors (9.4 mg/dl, n = 9) was not significantly different from that of the non-survivors (6.5 mg/dl, n = 13; P = 0.295). Quality of life was assigned a mean score of 8/10. Median survival of cats following discharge was 419 days (range 44-994 days). Signs consistent with sterile cystitis affected 35% of cats. It was concluded that ureteric stent placement in cats was associated with a 15% mortality rate before hospital discharge. Long-term management of ureteric stents is associated with a high rate of lower urinary tract signs.

摘要

本研究的目的是确定采用双猪尾输尿管支架治疗输尿管梗阻的猫的治疗结果,并记录长期随访时下尿路症状的发生率。回顾性收集了2009年至2012年期间26只接受输尿管支架置入术的猫的病历资料。与猫主人联系进行随访,并完成了一份生活质量问卷。支架置入术后出院生存率为85%(22/26)。术后因尿腹症需要进一步手术的发生率为15%(4/26)。4只猫分别因支架移位、断裂、结壳导致管腔梗阻或无菌性膀胱炎,在初次手术后4至28个月更换了支架。9只猫在随访时存活,随访时间为初次手术后3至28个月。9只猫患有氮质血症性慢性肾病,9只猫有与无菌性膀胱炎相关的症状;其中3只猫因症状严重而实施了安乐死。存活猫(9.4mg/dl,n = 9)术前血清肌酐与非存活猫(6.5mg/dl,n = 13;P = 0.295)相比无显著差异。生活质量平均评分为8/10。猫出院后的中位生存期为419天(范围44至994天)。35%的猫出现了与无菌性膀胱炎相符的症状。得出的结论是,猫输尿管支架置入术在出院前的死亡率为15%。输尿管支架的长期管理与下尿路症状的高发生率相关。

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