盆腔器官肿瘤浸润或术后放疗致输尿管梗阻的处理

The management of ureteral obstruction caused by pelvic tumor or the radioactive therapy after operation.

目的 探讨盆腔器官肿瘤浸润或术后放疗致输尿管梗阻的诊治方法。方法 回顾性分析1990年6月至2000年5月经临床处理的15例本病的临床资料,其中双J管内引流或输尿管导管引流术6例,经皮肾穿刺造瘘术4例,行开放性肾造瘘术3例,输尿管皮肤造瘘术2例。结果 本组15例经尿流改道或内引流后全身状况及尿毒症症状很快好转,其中7例肾功能恢复正常,8例肾功能改善。结论 B超、输尿管逆行插管和/或磁共振尿路水成像(MRU)检查是较好的诊断手段。输尿管插管引流或双J管内引流和经皮肾穿刺造瘘术,具有损伤小、对患者影响轻的优点,是解除梗阻的首选方法。

Objective To discuss the diagnosis and treatment methods of ureteral obstruction caused by pelvic tumor or radioactive therapy after operation. Method Clinical data of 15 cases with ureteral obstruction were reviewed retrospectively .The treatment included retrograde stenting in 6 patients,percutaneous nephrostomy in 4 patients,open nephrostomy in 3 patients, cutaneous ureterostomy in 2 patients. Results All patients underwent the treating procedure successfully. 7 were become normal and 8 were improved for renal function. Conclusions It is considered that B - ultrasonography, ureter catheterization and MRU were better than other tests for diagnosis of obstructive position. Ureter catheterization or double J tube insertion and percutaneous nephrostomy should be the first measures to relieve obstruction.