盆腔肿瘤放疗执行前膀胱充盈一致性研究

Study on the bladder filling consistency of pelvic tumors prior to the radiotherapy

目的盆腔肿瘤患者放疗执行前,分析"体位固定""CT扫描""模拟复位"这3个步骤膀胱充盈程度保持一致性情况。方法2014年随机收治105例盆腔肿瘤放疗患者(宫颈癌68例、直肠癌32例、阴道癌3例、前列腺癌2例),监测膀胱尿量到目标尿量400 ml。首先,叮嘱患者排空膀胱,用膀胱容积测量仪BVI 9400测量患者膀胱排空时尿量。随后,患者立即饮水约540 ml,进行自主憋尿,每间隔0.5 h进行测量。同时,在患者主诉"尿急"时,测量膀胱尿量,并记录时间。排空时、排空后0.5 h、排空后1.0 h、主诉"尿急"时、实际时的尿量和时间描述为U0和t0、U0.5和t0.5、U1.0和t1.0、Ut和t、UT和T。结果性别和年龄因素导致憋尿能力不同,U1.0女性憋尿能力比男性强(P=0.003)、U1.0非老年组憋尿能力比老年组强(P=0.002)。在3个步骤对比中,排空后1.0 h尿量U1.0(P=0.177)、实际时尿量UT(P=0.052)具有一致性,最终尿量均集中在298~526 ml。患者排空尿量后首次主诉"尿急"的时间t为(75.2±49.9)min,此时尿量Ut为(331.2±140.3)ml。模拟复位时,Ut与UT相近(P=0.198)。结论患者排空膀胱后立刻喝水540 ml,自主憋尿1.0 h后有主诉"尿急"情况,并能达到目标尿量(400 ml),这时的膀胱尿量U1.0在体位固定、CT扫描、模拟复位有一致性。

Objective Before the radiotherapy was performed,patients with pelvic tumors were analyzed for the consistency of bladder filling in the three steps of"Immobilization","CT Simulation"and"X-ray Simulation".Methods In 2014,105 patients(68 cases of cervical cancer,32 cases of rectal cancer,3 cases of vaginal cancer and 2 cases of prostate cancer)with pelvic tumor radiotherapy were randomly assigned to monitor bladder urine volume to a target urine volume of 400 ml.First,patient were exhorted to empty the bladder,and the bladder volume meter BVI 9400 was used to measure the urine volume of the patient after emptying of the bladder.The patient immediately drank about 540 ml of water and suppressed urine,measurements were taken every 0.5 h.At the same time,when the patient complained of"urgency of urine",bladder urine volume would be measured again and the time would also be recorded.Every other half an hour(emptying,0.5 h after emptying,1.0 h after emptying),when complaining of"urgency of urine",when actually performing urine volume and time were described as:U0 and t0,U0.5 and t0.5,U1.0 and t1.0,Ut and t,UT and T.Results There was a statistically significant difference in gender and age,and women had stronger ability to urinate than men U1.0(P=0.003),young people had stronger ability to urinate than middle-aged U1.0(P=0.002).In the three-step comparison,there was no statistically difference between 1 hour after emptying urine volume U1.0(P=0.177)and the actually performing urine volume UT(P=0.052).And the final urine volume was concentrated at 298-526 ml.After the patient emptied the urine volume and complained of"urgency of urine",the time slot was t=(75.2±49.9)min,with the urine volume of Ut=(331.2±140.3)ml.And there was no statistically difference between Ut and UT(P=0.198)at X-ray Simulation.Conclusions The patient emptied the bladder and immediately drank 540 ml of water.After 1 hour of suppressing urine,he complained of"urgency of urine"and achieved the target urine volume(400 ml).At this time,the bladder urine volume U1.0 was consistency in the immobilization,CT Simulation,and X-ray Simulation.