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[DJ管结石形成物与原结石成分比较及其成因分析]

[Comparison of the composition of DJ tube encrustation and original stone and analysis of its causes].

作者信息

Zhang Y Y, Li G H

机构信息

Department of Urology, Sir Run Run Shaw Hospital, Hangzhou 310016, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2020 Apr 14;100(14):1084-1086. doi: 10.3760/cma.j.cn112137-20190718-01593.

Abstract

To compare the composition of DJ tube encrustation and original stone, and to discuss the causes and prevention of encrustations. Twenty-five patients with DJ tube encrustation (1 case of INLAY OPTIMA(®) tube, Bard Medical, 16 cases of Universa(®) Firm tube, Cook Medical, 8 cases of Polaris™ Loop tube, Boston Scientific) in our institution from Januarry 2018 to April 2019 wereretrospective analyzed. Stones and encrustations were analyzed using the Fourier transform infrared spectroscopy analysis system to compare the differences in composition. 76% (19/25) patients had the exact same DJ tube encrustations composition as the original stone component; 24% (6/25) patients had DJ tube encrustation and original stone composition inconsistent (5 cases of calcium oxalate stone, 1 case of apatite carbonate.) It maybe related to the control of urinary tract infection after ureteral obstruction. The earliest DJ tube with encrustation was a pre-expansion tube before flexible-ureteroscopy, and the indwelling time was only 18 days. DJ tubes of different brands and models have the risk of formation of encrustation. Most of the encrustation has the same composition as the original stone. The prevention of DJ tube scorpion can be started from: (1) removing the DJ tube within 6 weeks or replace it regularly when necessary; (2) selecting the appropriate tube including diameter and model; (3) actively controlling urinary tract infection; (4) treating the metabolic diseases, such as hypercalcemia, hyperuricemia, et al, and providing personalized guidance for each patient.

摘要

比较DJ管结石与原结石的成分,探讨结石形成的原因及预防措施。回顾性分析了2018年1月至2019年4月在我院发生DJ管结石的25例患者(1例INLAY OPTIMA(®)管,巴德医疗公司;16例Universa(®) Firm管,库克医疗公司;8例北极星™环管,波士顿科学公司)。使用傅里叶变换红外光谱分析系统对结石和结石进行分析,比较成分差异。76%(19/25)的患者DJ管结石成分与原结石成分完全相同;24%(6/25)的患者DJ管结石与原结石成分不一致(草酸钙结石5例,磷灰石碳酸盐结石1例)。这可能与输尿管梗阻后尿路感染的控制有关。最早出现结石的DJ管是软性输尿管镜检查前的预扩张管,留置时间仅18天。不同品牌和型号的DJ管都有形成结石的风险。大多数结石的成分与原结石相同。DJ管结石的预防可从以下方面入手:(1)6周内取出DJ管或必要时定期更换;(2)选择合适的管子,包括直径和型号;(3)积极控制尿路感染;(4)治疗代谢性疾病,如高钙血症、高尿酸血症等,并为每位患者提供个性化指导。

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