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与对照支架相比,Percuflex螺旋输尿管支架显著降低了患者的镇痛需求。

Percuflex Helical Ureteral Stents Significantly Reduce Patient Analgesic Requirements Compared to Control Stents.

作者信息

Chew Ben H, Rebullar Karla A, Harriman David, McDougall Elspeth, Paterson Ryan F, Lange Dirk

机构信息

Department of Urologic Sciences, University of British Columbia , Vancouver, British Columbia.

出版信息

J Endourol. 2017 Dec;31(12):1321-1325. doi: 10.1089/end.2017.0349. Epub 2017 Nov 20.

Abstract

INTRODUCTION AND OBJECTIVES

Ureteral stent symptoms are experienced by the majority of patients with ureteral stents. No one stent or technology has shown a clear advantage. The Helical™ stent, a spirally cut stent made of proprietary Percuflex™ material, was designed to conform to the shape of the ureter and better accommodate patient movement. We prospectively sought to compare unscheduled visits, analgesic use, and pain scores in patients who received a Percuflex Helical ureteral stent following ureteroscopy compared to a historical control group.

METHODS

Fifteen (n = 15) patients undergoing ureteroscopy for the treatment of kidney stones were consented for study. A Percuflex Helical ureteral stent was inserted after treating the urinary stone. The historical control group consisted of 30 patients, from a previous (ketorolac eluting) ureteral stent study utilizing the same protocol and clinical monitoring forms, who received a regular Percuflex ureteral stent. The control patients were matched by age and sex. The primary study outcome was to compare unscheduled visits. Secondary outcomes included comparison of Visual Pain Analog Scale (VPAS) scores and analgesic use between the two groups.

RESULTS

There were no differences in the gender, age, BMI, or stone characteristics between groups. Both groups underwent retrograde ureteroscopy using holmium:YAG laser lithotripsy and stone fragmentation. There was a significant reduction in the amount of analgesics required in the Helical stent group (4.4 ± 7.99 mg morphine equivalents) compared to controls (16.75 ± 18.31 mg, p = 0.0035) to achieve similar VPAS scores. There was no difference in unscheduled visits (20%) or VPAS scores (13.84 ± 13.68 helical vs 14.29 ± 11.58 control, p = 0.7910) between groups.

CONCLUSIONS

Patients who received a Percuflex Helical ureteral stent required significantly fewer analgesics than those who received a Percuflex stent and both had equivalent pain scores.

摘要

引言与目的

大多数输尿管支架置入患者都会出现输尿管支架相关症状。尚无一种支架或技术显示出明显优势。螺旋™支架是一种由专利Percuflex™材料制成的螺旋切割支架,设计用于贴合输尿管形状并更好地适应患者活动。我们前瞻性地比较了输尿管镜检查后接受Percuflex螺旋输尿管支架的患者与历史对照组在非计划就诊、镇痛药物使用和疼痛评分方面的差异。

方法

15例因肾结石接受输尿管镜检查治疗的患者同意参与研究。在治疗尿路结石后插入Percuflex螺旋输尿管支架。历史对照组由30例患者组成,他们来自之前一项(酮咯酸洗脱)输尿管支架研究,采用相同方案和临床监测表格,接受常规Percuflex输尿管支架。对照组患者按年龄和性别匹配。主要研究结局是比较非计划就诊情况。次要结局包括比较两组之间的视觉模拟疼痛量表(VPAS)评分和镇痛药物使用情况。

结果

两组在性别、年龄、体重指数或结石特征方面无差异。两组均采用钬激光碎石术经逆行输尿管镜进行结石粉碎。与对照组(16.75±18.31毫克,p = 0.0035)相比,螺旋支架组达到相似VPAS评分所需的镇痛药物量显著减少(4.4±7.99毫克吗啡当量)。两组在非计划就诊率(20%)或VPAS评分(螺旋组13.84±13.68 vs对照组14.29±11.58,p = 0.7910)方面无差异。

结论

接受Percuflex螺旋输尿管支架的患者所需镇痛药物明显少于接受Percuflex支架的患者,且两组疼痛评分相当。

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