部分解决方案和部分问题——澳大利亚三级转诊中心输尿管支架使用报告

V. Ilie, V. Ilie
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引用次数: 4

摘要

背景:本研究的目的是全面报告单一三级转诊中心输尿管支架使用的经验,评估并发症负担并确定风险因素,以进一步为机构实践提供信息。材料和方法:回顾性分析的队列包括529例在12个月期间接受治疗的患者。回顾性收集有关指数病理、支架特征和并发症的详细资料。结果:大多数支架(58.9%)用于结石手术。14.5%的患者发生支架结痂,4.3%的患者发生败血症。90天后取出支架的并发症(76.3%的结痂,26.8%的尿培养阳性)与其他队列存在统计学差异。总体而言,7.6%的患者因支架相关并发症(疼痛、血尿、败血症)再次就诊急诊,2.4%的患者需要早期移除支架。在我们的机构,我们设法避免了遗忘的支架和灾难性的并发症。结论:支架并发症是异物与收集系统环境相互作用的复杂结果,受手术性质和时机的影响。较长的支架停留时间与并发症发生率增加有关。规划最终的治疗和支架取出需要考虑具有显著合并症的亚组之间的统计学显著差异。
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Part of the Solution and Part of the Problem-Report on the Ureteric Stent Use in a Tertiary Referral Center in Australia
Background: The aim of the study is to comprehensively report on a single tertiary referral centre experience with the use of ureteric stents, assess complication burden and determine risk factors to further inform institutional practice. Materials and methods: The retrospectively analysed cohorts include 529 patients treated over a 12 months period. Data regarding details of the index pathology, stent characteristics and complications were collected retrospectively. Results: Most stents (58.9%) were used in the context of stone surgery. Stent encrustation occurred in 14.5% of patients and sepsis in 4.3%. There was a statistically significant difference be-tween the complications of the stents removed after 90 days (76.3% of encrustations, 26.8% positive urine cultures) and the rest of the cohort. Overall, 7.6% of patients re-presented to the emergency department due to stent related complications (pain, haematuria, sepsis) and 2.4% required early stent removal. At our institution, we managed to avoid forgotten stents and catastrophic complications. Conclusions: Stent complications are the complex outcome of interplay between the foreign body and the collecting system environment, influenced by the nature and timing of surgery. Longer stent dwelling times are associated with increased complications rates. Planning definitive management and stent extraction needs to take into account the statistically significant differences between the subgroups with significant co-morbidities.
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