输尿管支架结痂的原因分析以及石痂与原发结石成分的比较

目的探讨输尿管支架结痂的原因,比较石痂和原结石成分的异同,了解成因及预防。 方法回顾性分析我院2020年3月至2021年8月80例输尿管支架结痂泌尿系结石患者,及同期接受治疗的80例输尿管支架未结痂泌尿系结石患者的资料。采用结石红外光谱自动分析系统分析结石及石痂,对比其成分的差异。 结果结痂组与非结痂组患者的性别比例、年龄、肌酐、肾小球滤过率、肾积水情况、术前感染控制情况、尿培养情况、手术方式、结石部分、术后口服抗生素时间等差异均无统计学意义（P>0.05）。结痂组和非结痂组患者相比更容易出现腰痛（P<0.05）。结痂组和非结痂组患者相比患代谢综合征的比例高,结石清除率较低,尿pH值较高,饮食偏荤和喜饮茶者较多（P<0.05）。71.25%（57/80）患者的支架管石痂成分与原结石成分一致,28.75%（23/80）患者的支架管石痂与原发结石成分不一致,可能与感染控制不佳和代谢性疾病有关。 结论输尿管支架结痂这一并发症需要引起足够的重视,大部分的石痂与原发结石成分相同。可通过改变生活习惯,控制带管时间,积极控制尿路感染及治疗代谢性疾病预防。

Analysis the causes of ureteral stent encrustation and comparison of composition of encrustation and original stone

ObjectiveTo investigate the causes and prevention of encrustation formation of ureteral stent and compare the encrustation and original stone components. MethodsThe data of 80 patients with urinary calculi in our hospital from March 2020 to August 2021 and their primary calculi and ureteral stents with encrustation were collected. The data of 80 patients with urinary calculi without encrustation on ureteral stent were statistically analyzed. The composition of stones and encrustations were analyzed using infrared spectroscopy analysis system. ResultsThere was no significant difference in sex ratio, age, creatinine, glomerular filtration rate, hydronephrosis, preoperative infection control and postoperative oral antibiotic time between the two groups (P>0.05). The patients in encrustation group got more prone to low lumbago and hematuria (P<0.05). Compared with the non encrustation group, the patients in the encrustation group had higher incidence of metabolic syndrome, lower stone clearance rate, higher urinary pH, more meat eating and tea drinking (P<0.05). 71.25%(57/80) patients had the same encrustations composition as the original stone, 28.75%(23/80) patients had inconsistent stone composition, which may be related to poor infection control and metabolic diseases. ConclusionsThe complication of ureteral stent encrustation needs to be paid enough attention. Most of the encrustation are the same as the original stones. It can be prevented by changing living habits, controlling extubation time, actively controlling urinary tract infection and treating metabolic diseases.