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[双J输尿管导管:一种无并发症的方法?]

[Double-J ureteral catheter: a method without complications?].

作者信息

de Pétriconi R, Egghardt G, Frohneberg D, Hautmann R

机构信息

Urologische Abteilung Universität, Ulm, RFA.

出版信息

J Urol (Paris). 1987;93(5):259-61.

PMID:3693933
Abstract

Since 1978, 90 patients with hydronephrosis due to ureteral obstruction have been treated with indwelling double-J ureteral stents (104 Renoureteral units). In cases of temporary treatment (e.g. infected hydronephrosis) splints were left in situ between 1 week and 19 months (mean 15 weeks). If permanent ureteral splinting was necessary as a palliative measure (e.g. progressive carcinoma of pelvic organs) stents were left in situ 6 months up to 5 years (mean 16 months). Replacement of the indwelling double-J stents was carried out in 4 to 12 weeks intervals. The all-over complication rate was near 11% including kidney stone formation in 6 cases and septicaemia due to a clogged stents and pyonephrosis in 3 cases. In two cases after pelvic radiotherapy severe hemorrhage occurred due to erosion of the commun iliac artery. The catheters had been left in situ for 28 and 30 months. Relief of obstruction by indwelling ureteral stents in the majority of the patients can simply be achieved usually without severe technical problems. Nevertheless, a 11% complication rate require restriction to indication especially in cases of long term treatment and after radiotherapy. Urinary diversion by percutaneous nephrostomy is the method of choice to avoid disadvantage of indwelling ureteral splinting.

摘要

自1978年以来,90例因输尿管梗阻导致肾积水的患者接受了留置双J输尿管支架治疗(104个肾输尿管单位)。在临时治疗的病例中(如感染性肾积水),支架留置时间为1周-19个月(平均15周)。如果作为姑息措施需要永久性输尿管支架固定(如盆腔器官进行性癌),支架留置时间为6个月至5年(平均16个月)。留置双J支架每隔4-12周更换一次。总体并发症发生率接近11%,包括6例肾结石形成、3例因支架堵塞导致的败血症和肾积脓。盆腔放疗后有2例因髂总动脉侵蚀发生严重出血。导管分别留置了28个月和30个月。在大多数患者中,留置输尿管支架通常能简单地解除梗阻,且一般不存在严重的技术问题。然而,11%的并发症发生率要求严格掌握适应证,尤其是在长期治疗和放疗后的病例中。经皮肾造瘘进行尿液改道是避免留置输尿管支架缺点的首选方法。

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