关键词: 膀胱根治性切除术, 输尿管皮肤造口, 多功能输尿管造口支架, 传统输尿管造口内支架, 术后并发症, 肾功能

Abstract: Objective  To compare the application of multifunctional ureterostomy stent and traditional ureterostomy internal stent in patients with total ureterostomy.Methods  Prospectively,102 patients with bladder cancer and undergoing elective radical cystectomy with urinary diversion admitted to our hospital from March 2019 to March 2023 were selected for the study.According to the random number rank method,the patients were divided into the study group (51 cases) and the control group (51 cases).The control group was given a traditional singleJ ureteral stomy stent drainage device,and the research group was given a multifunctional ureteral stomy stent drainage device.The differences of OAI score,renal function index (eGFR),recent complications,long-term complications and quality of life (FACT-BL score) were compared between the two groups.Results  OAI scores 1 month,3 months and 6 months after surgery (study group:49.33±4.07,57.29±3.90,68.25±3.76;control group:44.25±4.61,52.31±4.58,59.06±4.37) and before surgery (study group:32.71±4.32;control group:33.18±4.74) compared with higher levels (P<0.05),but the study group was higher than the control group (P<0.05).Repeated measurement ANOVA results showed that eGFR at 3 months and 6 months after surgery (study group:86.07±4.07,88.01±3.01;control group:83.09±3.06,85.06±5.09) and before surgery (study group:82.05±6.04;control group:81.03±5.06) compared with higher levels (P<0.05),but the study group was higher than the control group (P<0.05).The total rate of recent complications in the study group was lower than that in the control group (7.84% VS 23.53%,P<0.05).The total incidence of long-term complications in the study group was lower than that in the control group (43.14% VS 78.43%,P<0.05).Emotional status score,physical status score,functional status score,social and family status score,BSS score,FACT-BL total score of the two groups 6 months after surgery (study group:20.25±2.36,24.92±1.87,25.65±1.11,26.02±1.14,32.75±1.76,129.59±5.74;Control group:18.65±3.10,20.18±3.02,23.51±1.29,21.51±2.24,30.26±3.07,114.10±10.37) and preoperative (study group:14.27±3.56,16.57±3.58,17.27±2.35,17.49±2.64,23.41±5.25,89.02±13.62;Control group:14.39±3.44,16.47±3.25,17.22±2.34,17.55±2.59,23.43±5.25,89.25±13.62) were increased (P<0.05),and the study group was higher than the control group (P<0.05).Conclusion  The application of multifunctional ureteral stent in patients with ureteral cutaneous stomy with total cystotomy can effectively improve the adaptability of stomy,promote the recovery of renal function,reduce the risk of short-term and long-term complications,and improve the quality of life of patients.

Key words: radical cystectomy, ureteral cutaneous stomy, multifunctional ureterostomy stent, traditional ureterostomy stent, postoperative complications, renal function