Patel U, Kellett M J
Department of Uroradiology, University College Hospitals Group, London, UK.
Br J Urol. 1996 Apr;77(4):530-5. doi: 10.1046/j.1464-410x.1996.09298.x.
To study peristalsis and drainage of the stented ureter under normal physiological conditions.
Fifteen non-obstructed patients with ureteric stents and 15 control subjects (i.e. 45 unstented ureters and 15 stented ureters) had ureteric jets and flow analysed using colour Doppler ultrasound (CDU). Cross-sectional and longitudinal studies were performed.
Unstented ureters had forceful ureteric jets at a frequency of 0.5-4 jets/min per ureter. Asymmetry of frequency within subjects was common (1-3 jets/min). Some patent stented ureters had no recordable flow on CDU (four cases, three within the first week of stenting). In the remainder, three types of flow pattern were recorded; weak peristaltic jets were seen in a minority (four of 15), flow around the stent (periprosthetic flow) in 11 of 15 and flow through the lumen (luminal flow) in eight of 15. Jets were only seen late after stenting (> 2 months). The periprosthetic flow was mildly peristaltic in some patients and periprosthetic and jet flow increased relative to luminal flow during peak diuresis.
Passive drainage (periprosthetic and luminal flow) is the principal mode of urine transport in the stented ureter throughout the diuretic response and particularly within a week of stenting. With longer duration of stenting (> 2 months) weak peristaltic activity and active ureteric transport became more evident, notably during peak diuresis. CDU is not reliable for diagnosing obstruction of the stented ureter.
研究正常生理条件下带支架输尿管的蠕动和引流情况。
15例输尿管带支架的非梗阻患者和15名对照者（即45条无支架输尿管和15条带支架输尿管），采用彩色多普勒超声（CDU）分析输尿管喷流和血流情况。进行了横断面和纵向研究。
无支架输尿管有有力的输尿管喷流，频率为每条输尿管每分钟0.5 - 4次喷流。受试者内部频率不对称很常见（每分钟1 - 3次喷流）。一些通畅的带支架输尿管在CDU上无血流记录（4例，其中3例在支架置入后第一周内）。其余患者记录到三种血流模式；少数患者（15例中的4例）可见微弱蠕动喷流，15例中的11例可见支架周围血流（假体周围血流），15例中的8例可见通过管腔的血流（管腔内血流）。喷流仅在支架置入后期（>2个月）出现。一些患者的假体周围血流有轻度蠕动，在利尿高峰期，假体周围血流和喷流相对于管腔内血流增加。
被动引流（假体周围血流和管腔内血流）是带支架输尿管在整个利尿反应过程中，尤其是在支架置入后一周内尿液输送的主要方式。随着支架置入时间延长（>2个月），微弱的蠕动活动和活跃的输尿管输送变得更加明显，尤其是在利尿高峰期。CDU对诊断带支架输尿管梗阻不可靠。
