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Objective To discuss the indications,feasibility and safety of fluoroscopy-guided retrieval of tracheal tubular metallic stents.Methods Between January 2010 to December 2014,fluoroscopy-guided retrieval of tracheal tubular metallic stent was performed in 45 patients.The stents included 36 covered stents and 9 naked stents.The mean retention time of the covered and naked stents was (3.2±0.7) months and (2.5± 1.2) months respectively.Before the retrieval of the 36 covered stents,granulation tissue hyperplasia in different degrees was observed at both ends of 15 stents,and stent fracture was found in 3 stents.Granulation tissue hyperplasia was seen in all 9 naked stents.Among the 9 naked stents,5 stents were completely embedded in the tracheal submucosal area,and 2 stents were fractured.Results Of the 45 stents,41 stents were successfully retrieved (success rate of 91.1％),including 34 covered stents (94.4％,34/36) and 7 naked stents (77.8％,7/9).Of the 41 patients whose stents were successfully retrieved,massive hemoptysis occurred in 4 patients with a mean bleeding amount of 100 ml,tracheal mucosa tear was detected in 5 patients,emergency airway stent implantation because of tracheal collapse after stent retrieval was needed in one patient,and emergency surgical suture of the trachea due to tracheal rupture was carried out in one patient.No procedure-related death occurred.Conclusion The indications of fluoroscopy-guided retrieval of tracheal tubular metallic stents include stent fracture,local excessive proliferation of granulation tissue or tumor tissue that causes tracheal restenosis,temporary tracheal stent placement for benign tracheal stenosis,intolerance to stent implantation,etc.The technique of fluoroscopy-guided retrieval of tracheal tubular metallic stent is relatively safe and less invasive;this technique can solve the complications induced by long-term retention of the stents.
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Objective To study the effect of evidence-based nursing on improving the nursing requirement of patients with ureter external drainage and inner stent drainage after urological operation. Methods 62 patients in department of urinary surgery from June 2009 to October 2011 were selected as research object,and they were randomly divided into the control group and the observation group with 31 cases in each group,the two groups adopted routine nursing mode and evidence-based nursing mode respectively.Then the nursing requirement and nursing effect before and three and five days after nursing were compared between two groups. Results All the patients existed needs of related knowledge guidance,unhealthy emotion adjustment and social support,and the needs of patients between ureter external drainage and inner stent drainage showed no significant differences,improvement level of each items of the observation group after nursing were all better than those of the control group. Conclusions The patients with ureter external drainage or inner stent drainage have needs of related knowledge guidance,unhealthy emotion adjustment and social support,and the evidence-based nursing mode can effectively improve the patients'demand situations of these items.