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[输尿管支架表面对结石形成和生物膜形成的影响]

[The impact of ureteral stent surface on encrustation and biofilm formation].

作者信息

Tsukanov A Yu, Akhmetov D S, Blesman A I, Rogachev E A

机构信息

Omsk State Medical University of Minzdrav of Russia.

Department of Surgical Diseases and Urology for PE, Omsk, Russia.

出版信息

Urologiia. 2018 May(2):40-45.

Abstract

INTRODUCTION

Encrustation and biofilm formation is a clinical problem occurring with indwelling urinary drainage devices routinely used in urological practice.

AIM

To investigate the impact of ureteral stent surface on encrustation and biofilm formation.

MATERIALS AND METHODS

Polyurethane stents of two manufacturers were examined using the scanning electron microscopy and scanning probe microscopy before use and three weeks after their initial ureteral placement in patients with no evidence of a urinary tract infection and urolithiasis.

RESULTS

In one case, there were irregularities in the form of pyramids with a height of 0.15+/-0.02 m with a tendency to occur at regular intervals, forming ordered rows, with a density of 2.67 per 10 m2. The cross-sectional area of the irregularities in the probe displacement direction was 1.015 m, after use - 1.271 m (25.2% increase). In another case, pyramids with a height of 0.39+/-0.03 m (p<0.0001) were detected without the pattern of repetition in the form of a network, the density was 3.31+/-10 m2. The cross-sectional area of the irregularities was 1.158 and 2.29 m2, respectively (an increase of 97.8%). In the first case, after three weeks of stent placement, the pyramids increased twofold, were amenable to counting, the biofilms had the appearance of scattered "loose" formations. In the second case, there were polygonal conglomerates of salts dozens of times larger than the primary elements; biofilms had the appearance of well-formed massive layers.

CONCLUSION

The nature of the ureteral stent surface exerts a direct independent effect on the degree of encrustation and the formation of biofilms.

摘要

引言

结壳和生物膜形成是泌尿外科实践中常规使用的留置导尿装置所出现的临床问题。

目的

研究输尿管支架表面对结壳和生物膜形成的影响。

材料与方法

在无尿路感染和尿路结石证据的患者中,对两家制造商生产的聚氨酯支架在初次输尿管置入前及置入三周后进行扫描电子显微镜和扫描探针显微镜检查。

结果

在一个案例中,存在高度为0.15±0.02μm的金字塔形不规则物,有以规则间隔出现的趋势,形成有序排列,每10μm²密度为2.67个。在探针位移方向上不规则物的横截面积在使用前为1.015μm²,使用后为1.271μm²(增加25.2%)。在另一个案例中,检测到高度为0.39±0.03μm(p<0.0001)的金字塔形不规则物,无网络形式的重复模式,密度为3.31±10μm²。不规则物的横截面积分别为1.158和2.29μm²(增加97.8%)。在第一个案例中,支架置入三周后,金字塔形不规则物增加了两倍,易于计数,生物膜呈现分散的“松散”结构外观。在第二个案例中,有比主要成分大几十倍的多边形盐块聚集体;生物膜呈现结构良好的块状层外观。

结论

输尿管支架表面的性质对结壳程度和生物膜形成有直接独立影响。

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