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目的:研究长期留置输尿管内支架对肾功能的影响。方法:收集2011年1月至2014年12月在广州医科大学附属第一医院长期留置并定期更换输尿管内支架的46例功能性独肾或双侧输尿管梗阻患者的临床资料。按照更换输尿管内支架时间分成5组(基线组、放管时间≤12个月组、≤18个月组、≤24个月组、>24个月组),分析各组血清肌酐值、肾小球滤过率(eGFR);对肾功能减退因素进行单因素分析。结果:不同置管时间组的肌酐值、eGFR与基线比较,差异均无统计学意义(P>0.05);46例患者中16例肾功能改善、23例肾功能减退,尿培养阳性、肾积液增加与肾功能减退相关(P<0.05)。结论:长期间隔更换输尿管内支架可以解决复杂性输尿管梗阻并保护患肾功能,但与输尿管内支架管相关的尿路感染和尿液反流会导致患肾功能损害。
Objective: To study the effect of long-term ureteral stent on renal function. METHODS: The clinical data of 46 patients with functional single or bilateral ureteral obstruction who were permanently placed in the First Affiliated Hospital of Guangzhou Medical University from January 2011 to December 2014 were retrospectively analyzed. According to the time of replacing the ureteral stent, the rats were divided into 5 groups (baseline group, discharge time≤12 months, ≤18 months, ≤24 months,> 24 months), serum creatinine, Ball filtration rate (eGFR); univariate analysis of factors of renal dysfunction. Results: There were no significant differences in creatinine and eGFR between baseline and baseline (P> 0.05). Among the 46 patients, 16 had improved renal function, 23 had renal dysfunction, positive urine culture, Increased fluid was associated with decreased renal function (P <0.05). CONCLUSIONS: Long-term replacement of ureteral stents resolves complex ureteral obstruction and protects renal function, but urinary tract infections and urinary reflux associated with ureteral stent-graft can lead to impaired renal function.