记忆合金网状支架治疗输尿管狭窄的长期随访报告

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l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。

Shape-memory alloy net-like stent for the management of ureteral stricture: a long-term follow-up report

Objective To investigate the long-term outcome of treatment of ureteral stricture with shape-memory alloy net-like stent. Methods Nickel-titanium shape-memory alloy net-like stent was used to treat 9 patients with ureteral stricture, 4 males and 5 females, aged 41 (29~63), with the length of ureteral stricture of 1.0~4.0 cm , the etiology being radical operation for rectal carcinoma in 2 cases, chronic inflammation in 3 case, and operation for benign diseases in 4 cases. A total of 10 stents were inserted under spinal anesthesia. The mean follow-up time was 27.2 months (5~96 months). Results Ureteral obstruction was relieved in 7 cases (77.8%) with the relief or disappearance of hydronephrosis. The ureteral stents were blocked and re-obstruction appeared in 2 cases within 5~6 months due to hyperplasia of fibrous tissue. One of the cases underwent removal of stent and the other case underwent insertion of double-J with improvement of renal function. No radiological evidence of migration of stent and encrustation was found. Conclusion More tolerable and with less side-effect and lower re-stricture rate, shape-memory alloy stent is better then Double-J in treatment of ureteral obstruction.