终生带管患者应用抗肿瘤输尿管支架管的临床研究

朱楷林; 李帅; 李勇辰; 耿玉涛; 王志杰; 武玉东

doi:10.13201/j.issn.1001-1420.2021.05.012

终生带管患者应用抗肿瘤输尿管支架管的临床研究

- 郑州大学第一附属医院泌尿外科(郑州, 450000)

详细信息

通讯作者: 武玉东,E-mail:wydkw@163.com

中图分类号: R693

收稿日期: 2020-07-06

Clinical study on the application of anti-tumor ureteral stent in patients with lifelong stenting

- Department of Urology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000, China

More Information

Corresponding author: WU Yudong, E-mail: wydkw@163.com

Received Date: 06 July 2020

摘要

摘要: 目的:检验终生带管患者使用抗肿瘤输尿管支架管的有效性与安全性以及探讨导致置管失败的预测因素。方法:回顾性分析2017年6月—2020年6月103例终生带管患者的临床资料,通过χ²检验分类变量,Student t检验方差相等的连续变量,非参数检验方差不相等的连续变量,二元logistic回归分析支架管置管失败预测因素。结果:103例患者共尝试242次支架管置入术,置管成功率为89.3%,支架管有效持续总时间为(16.06±18.20)个月,支架管更换次数为(3.04±3.04)次,支架管的轻微并发症发生率为48.1%。抗肿瘤支架管置管后对于降低患者血清尿素浓度、血清肌酐浓度、肾盂分离距离和改善肾小球滤过率均有统计学意义(P<0.05)。多因素二元logistic回归分析显示,术前肾盂积水程度3~4级、膀胱镜下肿瘤是否侵犯膀胱三角区及输尿管口均为支架管置入失败的独立预测因素(P<0.05)。结论:终生带管患者应用抗肿瘤输尿管支架管是安全、有效的,越早识别并应用抗肿瘤输尿管支架管,支架管的置入成功率越高。
- 输尿管梗阻 /
- 支架管 /
- 姑息治疗
Abstract: Objective: To test the efficacy and safety of using anti-tumor ureteral stent in patients with lifelong stenting, and to explore the predictors of stent failure.Methods: The clinical data of 103 patients with lifelong stenting from June 2017 to June 2020 were retrospectively analyzed. Chi-square was used to test categorical variables. Student's t-test was used for continuous variables with equal variances. Nonparametric tests was used for continuous variables with unequal variances. Binary logistic regression was used to analyze the predictive factors of stent failure.Results: A total of 242 times of stenting were attempted in 103 patients, and the success rate was 89.3%. The effective duration of stent was(16.06±18.20) months, and the number of stent replacement was(3.04±3.04) times. The incidence of minor complications was 48.1%. After anti-tumor stent being used, there was statistically significant decrease in serum urea concentration, serum creatinine concentration, renal pelvis separation distance and improvement in glomerular rate filtration(P<0.05). Multivariate logistic regression analysis showed that preoperative hydronephrosis grade 3-4, trigone of bladder and ureteral orifice tumor invasion under cystoscope were independent predictors of stenting failure(P<0.05).Conclusion: It is safe and effective to use the anti-tumor ureteral stent in the patients with lifelong stenting. The earlier we identify and apply the anti-tumor ureteral stent, the higher success rate of stent placement we get.
- ureteral obstruction /
- stent /
- palliative care

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