收稿日期：2023-02-10 接受日期：2023-02-10 出版日期：2023-02-10 发布日期：2023-02-10
通讯作者： 张龙洋,主任医师,教授,山东大学附属济南市中心医院泌尿外科科主任,山东第一医科大学附属中心医院 泌尿外科，济南 250013
作者简介： 赵腾飞,山东第一医科大学附属中心医院 泌尿外科，济南 . 高兴华,山东第一医科大学附属中心医院 泌尿外科，济南 . 郭龙飞,山东第一医科大学附属中心医院 泌尿外科，济南 . 张龙洋,男,山东第一医科大学附属中心医院 泌尿外科，济南 250013,主任医师,教授,山东医学会泌尿外科分会副主任委员，山东省医师协会男科学医师分会副主任委员，山东省医师协会內镜医师分会委员、无瘢痕医师协会委员。山东省抗癌协会泌尿男科分会委员，山东省医学会医疗事故鉴定专家组成员，山东省医学会司法鉴定中心临床法医鉴定人 .
基金资助：，项目负责人： 张龙洋
中图分类号：R322.6
文献标识码：A
文章编号：1674-7410(2022)02-0045-06
DOI：10.20020/j.CNKI.1674-7410.2022.02.10
摘要：输尿管支架管是泌尿外科常用的辅助工具，常用于相关科室提前留置便于术中辨认输尿管位置，以及输尿管腔内术后留置减少相关并发症。但输尿管支架管本身作为异物留存体内仍会引起一些并发症，常见的有血尿、泌尿系统感染、下尿路症状、腰部不适、输尿管支架管结垢等，罕见并发症由输尿管支架管遗忘、移位而导致。本文就留置输尿管支架管的相关并发症及防治的研究进展做一综述。
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[1]赵腾飞,高兴华,郭龙飞,张龙洋.留置输尿管支架管的并发症及其防治[J].泌尿外科杂志(电子版),2022,14(02):45-50.DOI:10.20020/j.CNKI.1674-7410.2022.02.10.
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输尿管支架管 （ureteral stent） 常见的类型包括双 J型管 （double-J stent，又称双猪尾管） 和单 J型管 （single-J stent），1978年 FINNEY 等[1]首次提出了双 J型输尿管支架管的概念。在随后的几十年随着技术的发展，输尿管支架管的类型越来越多，如解决输尿管狭窄的金属支架管等[2]。
输尿管支架管通常用于协助治疗尿石症，防止因输尿管水肿或结石碎片和血块通过而引起的梗阻、输尿管狭窄、绞痛和肾功能衰竭[3]，以及缓解良性或恶性梗阻、促进输尿管愈合、管理尿瘘或术前放置以帮助术中识别输尿管[4]，具有内引流和内支撑的作用[5]。理想的输尿管支架管应该易于置入和移除，具有良好的位置稳定性、成像可见度、生物相容性，确保尿流的连续性，不会引起反流，抗结垢，处理过程完成后可生物降解等[6]。目前泌尿外科最常见、应用最广泛的输尿管支架管仍然是双 J型输尿管支架管，但其在应用过程中存在一些并发症。因此本文主要将留置双 J型输尿管支架管相关并发症及防治的研究进展做一综述。
8 小结与展望
大多数留置输尿管支架管的患者都会携带支架管出院，由于缺乏对留置的支架管的重视及相关的知识，不良的遵医行为等都会导致并发症的发生[62]。为了预防这些并发症，每一位进行输尿管支架管置入术的医生都应该了解支架管的技术特征，当遇到并发症时，应该能够识别并解决，防止情况进一步恶化[63]。预防或减轻这些并发症的多种方法正在研究中，包括支架结构和设计、生物材料和涂层、新的输尿管支架管相关评分系统等。当下 COVID-19的影响可能仍会持续，需要探索新的方法来减轻影响和危害，为支架管留置患者提供支持，这是挑战同时也是机遇[45]。未来随着科技的发展，有望生产出新型的输尿管支架管，从而减少并发症，减轻患者痛苦。
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