Resonance金属输尿管双J管在恶性疾病相关性输尿管梗阻中的应用

目的比较Resonance金属输尿管双J管和传统聚合物双J管在解除恶性疾病相关性输尿管梗阻中的应用。 方法回顾性分析中山大学附属第六医院2013年1月至2016年1月收治的69例晚期恶性肿瘤侵犯或压迫输尿管引起上尿路积液的病例资料，均由我科同一治疗组医师逆行置入Resonance金属输尿管双J管（RMU组）或传统聚合物双J管（T组）解除梗阻，RMU组肾盂分离（31±10）mm，上段梗阻15条，中下段梗阻53条，术前肌酐115.5（85.7）μmol/L；T组肾盂分离（29±7）mm，上段梗阻7条，中下段梗阻16条，术前肌酐104（101）μmol/L，两组一般资料比较差异无统计学意义（P>0.05），评估两组置管成功率、支架引流通畅率、支架引流持续时间及并发症发生情况。 结果（1）共收集69例患者（91条输尿管单位）临床资料，进入Resonance金属双J管组并进行后续研究者50例（68条输尿管单位），平均随访250 d；进入传统聚合物双J管组并进行后续研究者19例（23条输尿管单位），平均随访203 d。（2）Resonance金属双J管组和传统聚合物双J管组置管成功率的差异无统计学意义（89.7% vs 87.0%，P>0.05），在30 d、60 d、90 d各时间点，Resonance金属双J管组引流通畅率均明显高于传统聚合物双J管组，且平均引流持续时间明显长于传统聚合物双J管组，差异有统计学意义（P<0.05）。（3）Resonance金属双J管组总的并发症发生率明显低于传统聚合物双J管组（46.0% vs 73.7%），差异有统计学意义（P<0.05）。 结论Resonance金属双J管用于解除恶性疾病相关性输尿管梗阻时，置管成功率与传统聚合物双J管相当，引流效果优于传统聚合物双J管，且并发症较少。

Application of Resonance metallic ureteral double J tube in ureteral obstruction associated with malignant diseases

ObjectiveTo compare the effecacy of Resonance metallic ureteral double J tube and traditional polymer double J tube in the removal of ureteral obstruction associated with malignant diseases. MethodsThe medical records of 69 patients with upper urinary tract hydrops caused by invasion of advanced malignant tumors or compression of ureter treated in the Sixth Affiliated Hospital of Sun Yat-sen University from January 2013 to January 2016 were analyzed retrospectively. All patients treated with retrograde placement of Resonance ureteral metallic double J tube (RMU group) or traditional polymer double J tube (T group) to remove the obstruction which was carried out by the same physicians in the department. In RMU group, the renal pelvis separation, number of upper ureteral obstruction, number of distal obstruction and the level of preoperative creatinine were (31±10) mm, 15, 53 and 115.5(85.7) μmol/L, respectively, while those in T group were (29±7) mm, 7, 16 and 104(101) μmol/L, respectively (P>0.05). The success rate of intubation, patency rate of stent drainage, duration of stent drainage and the incidence of complications in the two groups were evaluated. ResultsThe clinical data of 69 patients (91 ureteral units) were collected and 50 patients (68 ureteral units) were included in the RMU group and were followed up for an average of 250 days. Nighteen patients (23 ureteral units) were included in T group and were followed up for an average of 203 days. There was no statistically significant difference between the two groups in the success rate of intubation (89.7% vs 87.0%, P>0.05). The patency rates of drainage in RMU group were significantly higher than those in T group, and the average duration of drainage was significantly longer than that of T group (P<0.05). The total incidence of complications in RMU group was lower than that in T group (46.0% vs 73.7%) (P<0.05). ConclusionThe success rate of inserting Resonance metallic double J tube is similar to that of traditional polymer double J tube in relieving ureteral obstruction associated with malignant diseases. However, the drainage effect of the former is better than the latter, and the complications are fewer.