金属支架置入术治疗恶性肿瘤性输尿管梗阻疗效及对生活质量的影响

Curative efficacy and effects of metal stent implantation for malignant ureteral obstruction

目的观察金属支架置入术治疗恶性肿瘤性输尿管梗阻疗效及对患者生活质量的影响。方法收集42例恶性肿瘤性输尿管梗阻患者作为观察对象,回顾性分析其临床资料,所有患者均给予输尿管硬镜下逆行金属支架置入术治疗。治疗前后,观察临床疗效,比较患者治疗前后生活质量。结果患者行输尿管硬镜下逆行金属支架置入术均成功。术后,患者腰疼、腰胀临床症状显著改善,尿量明显增加,肾功能于术后2~7 d逐渐恢复正常。术后出现感染3例,尿路刺激症状4例,并发症发生率为16.7%,经治疗后均好转。与治疗前相比,患者治疗后躯体功能、角色功能、情绪功能、认知功能及社会功能等反映生活质量评分均提高,比较都有统计学差异(P均<0.05)。结论金属支架置入术是恶性肿瘤性输尿管梗阻的安全有效治疗方法,能够明显改善患者临床症状和肾功能,并发症发生率低,而且能够显著提高生活质量,临床上值得应用。

Objective To investigate curative efficacy of metal stent implantation for malignant ureteral obstruction and its influence on patients＇ lives. Methods 42 patients with malignant ureteral obstruction were treated with metal stent implantation under ureteroscope.Then the efficacy of this operation and life quality of these patients were observed and compared before and after treatments. Results Surgery of all patients was successful. After surgery, the symptoms of lumbago, waist expansion and urinary volume were significantly improved compared with those before treatment. Renal function of all patients recovered from 2 to 7 days after surgery. There were 3 cases of infection and 4 cases of urinary irritation after surgery（16.7%）, but all of them were cured after treatment. Compared before, scores of somatic function, role function, emotion function, cognitive function and social function were significantly improved after treatment（P0.05）. Conclusion Metal stent implantation is effective for malignant ureteral obstruction and is worthy of application. And it can improve the symptoms, renal function and life quality of patients with malignant ureteral obstruction.