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三种不同输尿管支架的疗效及膀胱刺激症状比较:一项双盲、前瞻性、随机对照试验

Comparison of efficacy and bladder irritation symptoms among three different ureteral stents: a double-blind, prospective, randomized controlled trial.

作者信息

Lee Jun Nyung, Kim Bum Soo

机构信息

Department of Urology, School of Medicine, Kyungpook National University , Daegu , Republic of Korea.

出版信息

Scand J Urol. 2015 Jun;49(3):237-41. doi: 10.3109/21681805.2014.981205. Epub 2014 Nov 27.

Abstract

OBJECTIVE

Various ureteral stents have been developed to reduce ureteral stent-related discomfort. The aim of this prospective, randomized study was to compare the efficacy and morbidity of three different ureteral stents.

MATERIALS AND METHODS

Between June 2012 and May 2013, patients who underwent ureteral stent insertion after ureteroscopic stone removal were randomized in a double-blind fashion to receive three different stents (group 1, Endo-Sof™ double-pigtail ureteral stent, Cook Medical; group 2, Enhanced Durometer loop stent, Bioteq; group 3, Polaris™ Ultra ureteral stent, Boston Scientific). Ninety patients who met the inclusion criteria were administered the International Prostate Symptom Score (IPSS) and Overactive Bladder Symptom Score (OABSS) preoperatively, after 2 weeks with the stent in situ and 4 weeks after its removal. The Visual Analogue Pain Scale (VAPS), presence of gross hematuria and ultrasound for hydronephrosis grade were checked at 2 weeks with the stent in situ and 4 weeks after its removal.

RESULTS

After stent insertion, the degree of hydronephrosis was not significantly different among the three groups. Patients in group 3 showed significantly less increase in the total IPSS and storage symptom subscores than did those in the other groups. Mean VAPS after ureteral stent insertion was significantly lower in group 3 than in the other groups. The presence of gross hematuria after ureteral stent insertion occurred more frequently in groups 1 and 2 than in group 3.

CONCLUSIONS

The Polaris Ultra ureteral stent showed similar efficacy and favorable tolerability in regard to bladder irritation symptoms, stent-related pain and presence of gross hematuria compared with other stents.

摘要

目的

已研发出各种输尿管支架以减轻与输尿管支架相关的不适。这项前瞻性随机研究的目的是比较三种不同输尿管支架的疗效和发病率。

材料与方法

在2012年6月至2013年5月期间,输尿管镜下取石术后接受输尿管支架置入的患者以双盲方式随机分组,接受三种不同的支架(第1组,Endo-Sof™双猪尾输尿管支架,库克医疗公司;第2组,增强硬度环支架,Bioteq公司;第3组,北极星™超输尿管支架,波士顿科学公司)。90名符合纳入标准的患者在术前、支架置入2周后和取出4周后接受国际前列腺症状评分(IPSS)和膀胱过度活动症症状评分(OABSS)。在支架置入2周后和取出4周后,检查视觉模拟疼痛量表(VAPS)、肉眼血尿情况以及肾积水程度的超声检查结果。

结果

支架置入后,三组肾积水程度无显著差异。第3组患者的IPSS总分及储尿症状子评分的增加显著低于其他组。第3组输尿管支架置入后的平均VAPS显著低于其他组。输尿管支架置入后,第1组和第2组肉眼血尿的发生率高于第3组。

结论

与其他支架相比,北极星超输尿管支架在膀胱刺激症状、支架相关疼痛和肉眼血尿方面显示出相似的疗效和良好的耐受性。

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