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目的探讨妇产科血管性介入治疗恶性肿瘤对泌尿系统损伤的类型、原因及处理。方法广州市第一人民医院1999年6月至2004年12月对89例妇科恶性肿瘤行血管性介入治疗的病例进行回顾性分析,探讨泌尿系统损伤的发生率、损伤类型、原因、治疗措施及结局。结果89例妇科恶性肿瘤介入治疗后发生的泌尿系统损伤共13例,包括膀胱、输尿管和肾脏的损伤,发生率为14.61%。13例中有5例只有1种损伤,其余8例均为2种或3种损伤并存,但肾脏的损伤不是直接的,而是继发于输尿管损伤。13例中子宫颈癌共5例,以输尿管损伤和继发肾脏损害为主者4例,占总发生率的30.77%(4/13),膀胱损伤仅有1例,占总发生率的7.70%(1/13);子宫体恶性肿瘤共8例,以膀胱损伤为主者7例,占总发生率的53.85%(7/13),输尿管损伤和继发肾损害仅有1例,占总发生率的7.70%(1/13)。13例中只有2例造成器官严重或不可逆的损伤,其余11例均在治疗后康复。结论血管性放射介入治疗存在对泌尿系统损伤的危险,采取恰当的措施可以预防损伤的发生。
Objective To investigate the types, causes and treatment of urinary tract injuries in gynecologic and gynecological vascular patients undergoing interventional therapy. Methods Guangzhou First People ’s Hospital from June 1999 to December 2004 89 cases of gynecological malignant tumor vascular interventional treatment cases were analyzed retrospectively to explore the incidence of urinary tract injury, injury types, causes, treatment measures and ending. Results Totally 13 cases of urinary system injury occurred in 89 cases of gynecologic malignancies after interventional therapy, including bladder, ureter and kidney, the incidence was 14.61%. Of the 13 cases, only 5 had a single injury, and the remaining 8 had 2 or 3 lesions, but the injury to the kidney was not direct, but secondary to ureteral injury. 13 cases of cervical cancer in 5 cases, mainly ureteral injury and secondary renal damage in 4 cases, the total incidence of 30.77% (4/13), only 1 case of bladder injury, the total incidence of 7.70 % (1/13). There were 8 cases of uterine malignant tumor, 7 cases were mainly bladder injury, accounting for 53.85% (7/13) of the total, only 1 case of ureteral injury and secondary renal damage, accounting for The total incidence of 7.70% (1/13). Only 2 of 13 cases caused serious or irreversible damage to the organ, and the remaining 11 recovered after treatment. Conclusion There is a risk of urinary tract injury to vascular interventional therapy. Appropriate measures may be taken to prevent the injury.