输尿管逆行插管在中晚期宫颈癌中的应用

The application of retrograde ureteral catheterization in advanced Cervical cancer

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 the application of retrograde ureteral catheterization in advanced cervical cancer.Methods From January 2005 to August 2010,23 cases of hospitalized patients with advanced cervical cancer in the retrograde ureteral catheterization were retrospectively analyzed.Obstetrics and Gynecology by the International League（FIGO） clinical staging criteria,19 cases of cervical cancer Ⅲ b,Ⅳa period of 4 cases,pathologic types were squamous cell carcinoma,aged 25 to 60 years old.All newly diagnosed patients with unilateral hydronephrosis in 16 cases and bilateral hydronephrosis in 7 cases.All cases were treated with retrograde double-J ureteral catheter.According to clinical manifestations of cases before and after cannulation,blood urea nitrogen,creatinine and imaging were compared to understand the condition indicators of improvement.Results Clinical manifestations and renal accumulation of water in 23 cases underwent retrograde ureteral catheterization significantly improved compared with the preoperative catheter.Catheter significantly improved renal function,compared with the preoperative blood urea nitrogen tube 6.28±2.85 mmol/L,creatinine 93.55±44.41 μmol/L,GFR value of 81.30±25.43 ml/min,there were significant differences（P0.05）.Conclusion The retrograde ureteral catheter to renal insufficiency in cases with advanced cervical cancer was benefit for treatment,patients can reduce pain and prolong life.The method is simple,suitable,safe and clinical valuable.