宫颈癌根治术泌尿系损伤的临床分析

Clinical analysis on radical surgery of cervical cancer urinary tract injury

目的：手术是治疗早期宫颈癌的主要手段，本文回顾性分析宫颈癌根治术泌尿系损伤的发生率、探讨防治措施，以减少泌尿系损伤的并发症，提高患者生活质量。方法：对新疆肿瘤医院2003年1月-2008年1月收治的482例早中期子宫颈癌行根治术的患者进行回顾性分析。其中Ia期6例，Ib期131例，IIa期142例，IIb期；鳞癌：440例，腺癌：31例，其他类型：11例。结果：发生泌尿系损伤9例，发生率为1．9％。其中输尿管损伤7例，膀胱损伤2例，其发生率分别为1．5％，0．4％。结论：宫颈癌根治手术致泌尿系损伤是少见但较严重的并发症，对输尿管损伤及时发现及时修补可以避免术后尿瘘的发生，严格操作步骤仍然是子宫颈癌根治术泌尿系损伤防治的关键问题。

Objective： To retrospectively analyse the incidence of urinary tract injury in radical surgery of cervical cancer to explore the measures of prevention and treatment and to improve the patients＇ life quality. Methods： 482 cases of early and mid cervical cancer, undergoing radical surgery in Xinjiang Tumour Hospital during January 2003 to January 2008, were retrospectively analyzed.The stages were： 6 stage I a; 131 stage II a; 142 stage II a and 203 stage II b. Squamous cell carcinoma： 440 cases; adenocarcinoma： 31 cases; other types： 11. Results： Urinary tract injury occurred in 9 patients, the incidence rate was 1.9 percent, in which,7 cases ofureteral injury, 2 case of bladder injury, the incidence rate were 1.5%, 0.4% respectively. Conclusions： Urinary tract injury, caused by radical surgery of cervical cancer, is a rare but serious complication. Discovering and repairing ureteral injury in time can avoid urinary fistula. Strict operating steps are still the key to prevention and treatment of urinary tract damage caused by radical surgery for cervical cancer.