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目的报告镍钛形状记忆合金网状支架治疗输尿管狭窄的经验和长期随访结果。方法1995—2004年采用镍钛形状记忆合金网状支架治疗9例输尿管狭窄的患者,其中男4例,女5例,年龄29~63岁。输尿管狭窄段长1.0~4.0cm,其中直肠癌根治术后输尿管狭窄2例,输尿管慢性炎症狭窄3例,其余4例均为良性疾病术后输尿管狭窄。在腰麻下共放置了10个记忆合金网状支架,中位随访时间27.2个月(5~96个月)。结果7例患者在随访期内输尿管狭窄解除,肾积水缓解。2例患者术后5~6个月时因纤维肉芽组织增生而阻塞输尿管支架管腔,其中1例手术取出支架,另1例输尿管内留置双猪尾管(D-J管)引流。在随访期内,未出现支架移动、结石形成等并发症。结论记忆合金网状支架治疗输尿管狭窄与D-J管相比耐受性较好,副作用小,再狭窄率低。
Objective To report the experience and long-term follow-up of nickel-titanium shape memory alloy mesh stent for ureteral stricture. Methods From 1995 to 2004, 9 patients with ureteral stricture were treated with nickel-titanium shape memory alloy mesh stent, including 4 males and 5 females, aged 29-63 years. Ureteral stenosis ranged from 1.0 to 4.0 cm, including 2 cases of ureteral stricture after radical resection of rectal cancer, 3 cases of chronic ureteral stricture stenosis, and 4 cases of benign ureteral stricture. A total of 10 memory alloy mesh stents were placed under spinal anesthesia. The median follow-up time was 27.2 months (range 5 to 96 months). Results During the follow-up period, 7 patients were relieved of ureteral stricture and hydronephrosis. In 2 patients, the lumen of the ureteral stent was obstructed by the proliferation of fibrous granulation tissue 5 to 6 months after operation, of which 1 case was removed by stenting, and the other 2 cases were placed in ureter with double pigtail tube (D-J tube). During the follow-up period, no complications such as stent movement and stone formation occurred. Conclusion The memory alloy mesh stent treatment of ureteral stricture and D-J tube is better tolerated, fewer side effects, restenosis rate is low.