摘要
目的 探讨Allium覆膜金属输尿管支架置入维持性治疗特发性腹膜后纤维化(iRPF)所致输尿管狭窄的安全性和有效性。方法 回顾性分析2020年6月至2024年6月北京大学人民医院、北京航天中心医院、北京市昌平区中西医结合医院收治的诊断为iRPF所致输尿管狭窄患者的临床资料。所有患者均行Allium覆膜金属输尿管支架置入术,术后定期随访,观察手术成功率、支架通畅率、肾功能(血肌酐)、肾积水程度改善情况以及相关并发症。结果 纳入的27例患者(40侧输尿管)共置入45枚Allium覆膜金属输尿管支架,技术成功率为100%。中位随访时间为44个月。末次随访时,患者血肌酐中位数由术前的121.8μmol/L降至100.0μmol/L(P<0.001),肾盂宽度由术前的1.7 cm降至1.0 cm(P<0.001)。随访期间,主要并发症为支架移位(1例,3.7%),经内镜下调整后解决。一期支架通畅率为97.5%,经二次干预后二期通畅率为100%。结论 Allium覆膜金属输尿管支架置入术是治疗iRPF所致输尿管狭窄的一种安全、有效的微创治疗方法,能显著改善肾功能,解除梗阻,且长期通畅率良好。支架移位是其主要并发症,但发生率低,且可通过内镜干预成功处理。
Objective To evaluate the safety and efficacy of Allium covered metallic ureteral stent placement as a maintenance therapeutic strategy for ureteral stricture secondary to idiopathic retroperitoneal fibrosis(iRPF)through a multicenter retrospective observational study.Methods A retrospective analysis was conducted on clinical data of patients diagnosed with iRPF-induced ureteral stricture,treated at Peking University People's Hospital,Aerospace Center Hospital,and Beijing Changping District Hospital of Integrated Traditional Chinese and Western Medicine between June 2020 and June 2024.All patients underwent Allium covered metallic ureteral stent implantation.Regular postoperative follow-ups were performed to assess technical success rates,stent patency rates,renal function(serum creatinine levels),improvement in the degree of hydronephrosis,and associated complications.Results In this study,a total of 45 stents were implanted in 27 patients(40 renal units),achieving a technical success rate of 100%.The median follow-up duration was 44 months.At the final follow-up,the median serum creatinine level decreased significantly from 121.8μmol/L preoperatively to 100.0μmol/L(P<0.001).The median renal pelvic width also exhibited a significant reduction from 1.7 cm preoperatively to 1.0 cm(P<0.001).During the follow-up period,the primary complication was stent migration(1 case,3.7%),which was successfully managed endoscopically.The primary patency rate was 97.5%,and the secondary patency rate following re-intervention was 100%.Conclusion The implantation of Allium covered metallic ureteral stents constitutes a safe and effective minimally invasive therapeutic modality for managing ureteral stricture caused by iRPF.It significantly improves renal function,relieves obstruction,and demonstrates favorable long-term patency outcomes.Stent migration represents the principal complication;however,its incidence is low and it can be successfully addressed through endoscopic intervention.
作者
赵国栋
胡浩浦
王明瑞
边小龙
熊杰
张保
徐涛
胡浩
ZHAO Guodong;HU Haopu;WANG Mingrui;BIAN Xiaolong;XIONG Jie;ZHANG Bao;XU Tao;HU Hao(Department of Urology,Peking University People's Hospital/Applied Lithotripsy Institute,Peking University,Beijing 100044,China;Department of Urology,Beijing Changping District Hospital of Integrated Traditional Chinese and Western Medicine,Beijing 102200,China;Department of Urology,Aerospace Center Hospital,Beijing 100049,China)
出处
《医学新知》
2025年第12期1491-1495,I0012-I0014,共8页
New Medicine
