[1]卫中庆,易超然,宋涛,等.两端膨大式尿道记忆支架在神经源性排尿障碍的临床应用[J].第三军医大学学报,2009,31(19):1832-1834.
 WEI Zhong-qing,YI Chao-ran,SONG Tao,et al.Implantation of urethral stent with amphi-oncoides in patients with neurogenic voiding dysfunction[J].J Third Mil Med Univ,2009,31(19):1832-1834.
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《第三军医大学学报》[ISSN:1000-5404/CN:51-1095/R]

卷:
31卷
期数:
2009年第19期
页码:
1832-1834
栏目:
专题报道
出版日期:
2009-10-15

文章信息/Info

Title:
Implantation of urethral stent with amphi-oncoides in patients with neurogenic voiding dysfunction
作者:
卫中庆易超然宋涛罗锐孙则禹
南京大学医学院附属鼓楼医院泌尿外科
Author(s):
WEI Zhong-qing YI Chao-ran SONG Tao LUO Rui SUN Ze-yu
Department of Urology, Affiliated Drum Tower Hospital, Nanjing University Medical School, Nanjing 210008, China
关键词:
神经源性下尿路功能障碍尿道支架植入术
Keywords:
neurogenic lower urinary tract dysfunction urethral stent implantation
分类号:
R197.39;R694.5;R699.6
文献标志码:
A
摘要:
目的   制备个体化两端膨大式尿道支架治疗神经源性下尿路功能障碍患者,对其疗效作评估。   方法   对21例神经源性损伤致下尿路功能性梗阻患者采用个体化两端膨大式尿道支架,经尿道支架置入器植入后尿道(支架置于膀胱颈与尿道外括约肌之间)。对术前、术后的排尿量、剩余尿量、尿动力学指标、肾积水程度、血清肌肝及尿素氮等项指标作比较,评估疗效。   结果   获得随访的19例中,平均排尿量由234.3 ml增至385.4 ml,平均剩余尿量由327.3 ml降至45.2 ml,平均逼尿肌漏尿点压由63.1 cmH2O 降至32.4 cmH2O ,最大排尿压由126.0 cmH2O降至76.0 cmH2O ,最大尿流率由6.3 ml/s升至16.5 ml/s,肾积水程度及血清肾功能指标有改善(P<0.05),未有严重尿失禁及支架移位,1例有结石形成。   结论   应用个体化两端膨大式尿道记忆支架能减少了尿失禁和支架移位, 明显改善患者的排尿功能,减少膀胱剩余尿量,保护患者的肾功能,提高患者的生活质量,是治疗神经源性下尿路功能障碍的一种较好方法。
Abstract:
Objective   To introduce an improved implantation for urethral stent with amphi-oncoides in patients with neurogenic voiding dysfunction and to evaluate its curative effect.    Methods   Totally 21 cases with infrasacral neurogenic voiding dysfunction were treated by implanting individualized urethral stents with amphi-oncoides. The urethral stent was implanted between the bladder neck and the urethral external sphincter muscle by transurethral operation. The following preoperative parameters were used to evaluate the outcome by comparing with those postoperatively: urinary output, urine residual volume (URV), urodynamic tests, renal hydronephrosis degree, and blood serum inosine and urea nitrogen.    Results   In the 19 patients with follow-up, the parameters were improved significantly after operation. The average urinary output volume was increased from 234.3 ml up to 385.4 ml. The average urine residual volume was decreased from 327.3 ml down to 45.2 ml. The average detrusor leak point pressure was decreased from 63.1 cmH2O to 32.4 cmH2O. The average max voiding pressure was declined from 126.0 cmH2O to 76.0 cmH2O. The average Qmax was elevated from 6.3 ml/s up to 16.5 ml/s. Renal hydronephrosis degree, and blood serum inosine and urea nitrogen were improved significantly (P<0.05). No case has serious urinary incontinence or stent displacement. Urethral stone was found in one case.    Conclusion   This procedure is effective in treating neurogenic lower urinary tract dysfunction with no urinary incontinence and stent displacement. It protects the function of upper urinary tract and improves the life quality of those patients.

参考文献/References:

卫中庆,易超然,宋涛,等. 两端膨大式尿道记忆支架在神经源性排尿障碍的临床应用[J]. 第三军医大学学报,2009,31(19):1832-1834.

更新日期/Last Update: 2009-09-29