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10岁以下儿童患者输尿管支架失败:发生率及危险因素

Ureteral stent failure in pediatric patients under 10 years: occurrence and risk factors.

作者信息

Lee Yong Seung, Im Young Jae, Kim Sang Woon, Son Hee Seo, Lim Neddy Lee, Han Sang Won

机构信息

Department of Urology and Urological Science Institute, Yonsei University College of Medicine, Seoul, Republic of Korea.

Department of Urology and Urological Science Institute, Yonsei University College of Medicine, Seoul, Republic of Korea.

出版信息

Urology. 2015 Mar;85(3):659-63. doi: 10.1016/j.urology.2014.11.027.

Abstract

OBJECTIVE

To examine the occurrence of ureteral stent failure in pediatric patients aged <10 years and to determine risk factors for failure.

METHODS

We performed a retrospective cohort analysis of 100 patients who underwent ureteral stent insertion between January 2006 and December 2013. All patients were aged <10 years and were followed up until ureteral stent removal. Information regarding patient demographics, reason for stent insertion, duration of stent maintenance, stent diameter and length, and postoperative results was collected. Risk factors for stent failure were analyzed.

RESULTS

Ureteral stenting was performed in 114 ureter units. The median age at stenting was 34.1 months (interquartile range [IQR], 8.1-71.2 months), and the median duration of stent maintenance was 35.0 days (IQR, 21.0-44.3 days). A 3-Fr stent was used in 39.5% of patients. Stent failure was observed in 11 ureter units (9.6%) at a median of 11.5 days (IQR, 7.8-24.5 days) after insertion, and the stent was subsequently removed. Use of a 3-Fr ureteral stent was the only risk factor for the development of stent failure; the failure rate was 20.0% with this stent diameter.

CONCLUSION

Ureteral stenting was a useful procedure with a high success rate, even in patients aged <10 years. A 3-Fr ureteral stent was the only risk factor for stent failure; its substantial failure rate should be considered when deciding whether to insert a stent. Also, short-term re-evaluation after ureteral stent insertion is mandatory, especially with 3-Fr ureteral stents.

摘要

目的

研究年龄小于10岁的儿科患者输尿管支架失败的发生率,并确定失败的危险因素。

方法

我们对2006年1月至2013年12月期间接受输尿管支架置入术的100例患者进行了回顾性队列分析。所有患者年龄均小于10岁,随访至输尿管支架取出。收集了患者人口统计学信息、支架置入原因、支架维持时间、支架直径和长度以及术后结果。分析了支架失败的危险因素。

结果

共对114个输尿管单位进行了输尿管支架置入。支架置入时的中位年龄为34.1个月(四分位间距[IQR],8.1 - 71.2个月),支架维持的中位时间为35.0天(IQR,21.0 - 44.3天)。39.5%的患者使用了3F支架。在11个输尿管单位(9.6%)观察到支架失败,中位时间为置入后11.5天(IQR,7.8 - 24.5天),随后取出了支架。使用3F输尿管支架是支架失败发生的唯一危险因素;该支架直径的失败率为20.0%。

结论

输尿管支架置入术是一种成功率较高的有效手术,即使在年龄小于10岁的患者中也是如此。3F输尿管支架是支架失败的唯一危险因素;在决定是否置入支架时应考虑其较高的失败率。此外,输尿管支架置入后必须进行短期重新评估,尤其是使用3F输尿管支架时。

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