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长期的双J支架在移植中优于短期的单J支架
Christiaan A J Oudmaijer1, Kelly Muller1, Erika van Straalen1
1Division of Hepatobiliary and Transplantation Surgery, Department of Surgery, Erasmus MC Transplant Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands.
PloS one
|January 30, 2025
概括
双J尿管支架显著减少脏移植后的泌尿道并发症,与单J支架相比. 这种具有成本效益的方法降低了穿皮瘤 (PCN) 放置的需要,改善了患者的治疗结果.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 移植手术 移植手术
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
背景情况:
- 泌尿学并发症,特别是在移植后的尿管囊切除术后,导致显著的发病率和死亡率.
- 尿道支架可以减轻这些并发症,但最佳支架策略需要前性评估.
- 之前关于移植时尿道支架的研究是回顾性的,限制了最终的结论.
研究的目的:
- 为了前性地比较单-J与双-J尿管支架在脏移植接受者的疗效.
- 确定最有效的支架方法,以尽量减少泌尿系统并发症.
- 评估二次结果,包括尿路感染,成本效益和住院.
主要方法:
- 进行了一项非盲目的,单中心随机对照试验.
- 300名脏移植接受者被随机分配,接受单J或双J支架.
- 主要结局是皮肤穿术 (PCN) 的放置;次要结局包括感染,成本和入院时间.
主要成果:
- 在双J组 (4,5%) 中,皮肤穿术 (PCN) 的放置率明显低于单J组 (14,5%) (p = 0.003).
- 多变量分析证实双J支架具有保护性 (OR 0.26 [0.10,0.61]).
- 住院时间和成本效益分析有利于双J支架;其他次要结果是可比的.
结论:
- 与单个J支架相比,双J支架显著减少了移植后的泌尿学并发症.
- 双J方法具有非常高的成本效益.
- 建议移植外科医生优先使用双J支架,以尽量减少并发症风险.
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