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目的探讨逆行输尿管插管在中晚期宫颈癌中的应用。方法对2005年1月~2010年8月在我院住院治疗的23例中晚期宫颈癌患者行逆行输尿管置管的临床资料进行回顾性分析。采用国际妇产科联盟(FI-GO)的临床分期标准,宫颈癌Ⅲb期19例,Ⅳa期4例,病理类型均为鳞癌。年龄25~60岁。均为初诊患者,23例中晚期宫颈癌患者中单侧肾积水者16例,双侧肾积水者7例。所有患者均采用逆行输尿管双J导管。对置管前后患者临床表现、尿素氮、肌酐及影像检查指标进行比较,并了解病情改善情况。结果 23例患者均行逆行输尿管置管后临床表现及肾积水情况与置管术前比较明显好转。置管术后肾功能明显改善,置管后血尿素氮[(6.28±2.85)mmol/L]、肌酐[(93.55±44.41)μmol/L]、肾小球滤过率(GFR)总值[(81.30±25.43)ml/min]均较置管前降低,差异均有统计学意义(P<0.05)。结论逆行输尿管置管可使中晚期宫颈癌肾功能不全患者获得治疗机会,可以减轻病人痛苦,延长患者生命。该方法简便,适用,安全,具有临床应用价值。
Objective To investigate retrograde ureteral intubation in the application of advanced cervical cancer. Methods The clinical data of retrospective ureter catheterization in 23 patients with advanced cervical cancer admitted to our hospital from January 2005 to August 2010 were analyzed retrospectively. Using the clinical staging criteria of International Gynecology and Obstetrics Federation (FI-GO), 19 cases were stage Ⅲb cervical cancer and 4 cases were stage Ⅳa. All the pathological types were squamous cell carcinoma. Age 25 to 60 years old. Newly diagnosed patients were 23 cases of advanced cervical cancer in patients with unilateral hydronephrosis in 16 cases, bilateral hydronephrosis in 7 cases. All patients were retrograde ureter double J catheter. Before and after the tube in patients with clinical manifestations, urea nitrogen, creatinine and imaging indicators were compared and to understand the condition of the disease. Results All 23 patients underwent retrograde ureteral catheterization and clinical manifestations of hydronephrosis and catheterization were significantly improved. After catheterization, the renal function was significantly improved. The blood urea nitrogen [(6.28 ± 2.85) mmol / L], creatinine [(93.55 ± 44.41) μmol / L] and total glomerular filtration rate (81.30 ± 25.43) ml / min, respectively, compared with those before catheterization, the differences were statistically significant (P <0.05). Conclusion Retrograde ureteral catheterization can make patients with advanced cervical cancer with renal insufficiency the chance of treatment, which can alleviate the suffering of patients and prolong the life of patients. The method is simple, applicable, safe and has clinical application value.