化瘀通淋汤联合输尿管镜下双J管置管对盆腔肿瘤手术所致输尿管损伤的治疗效果观察

Therapeutic Effects of Huayu Tonglin decoction Combined with Indwelling double J Tube Under Ureteroscope on Ureteral Injury Caused by Pelvic Tumor Surgery

目的:观察化瘀通淋汤联合输尿管镜下双J管置管对盆腔肿瘤手术所致输尿管损伤的治疗效果,以期为临床治疗提供依据。方法:选择2015年1月—2021年12月佛山市三水区人民医院60例盆腔肿瘤手术所致输尿管损伤患者为研究对象,按照随机数字表法将患者分为对照组(n=30)和观察组(n=30),前者采用输尿管镜下双J管置管治疗,后者在前者治疗基础上使用化瘀通淋汤,比较2组输尿管损伤治疗效果、中医症候积分、血清白细胞介素(IL)-6、IL-8和肿瘤坏死因子(TNF-α)、表皮生长因子(EGF)、转化生长因子(TGF-β)-1、角化生长因子(KGF)、胱抑素(Cys-C)、尿素氮(BUN)和肌酐(Scr)水平。结果:除对照组有1例患者置管失败外,其他患者均经尿道输尿管镜下顺利置入双J管,术后CTU检查显示其患侧尿路连续性恢复,输尿管通畅。观察组中医疗效有效率与对照组无显著差异(P>0.05)。观察组治疗后血尿、腰痛、尿漏积分均低于对照组,血清IL-6、IL-8、TNF-α、EGF、TGF-β1、KGF、Cys-C、BUN和Scr水平低于对照组,差异均有统计学意义。结论:化瘀通淋汤联合输尿管镜下双J管置管对盆腔肿瘤手术所致输尿管损伤的治疗效果较好,能够有效改善患者症状,较好修复受损输尿管。

Objective:To observe the therapeutic effect of Huayu Tonglin decoction combined with ureteroscopic double-J tube catheterization on ureteral injury caused by pelvic tumor surgery,in order to provide a basis for clinical treatment.Methods:From January 2015 to December 2021,60 patients with ureteral injury caused by pelvic tumor surgery in Sanshui District People’s Hospital of Foshan City were selected as the research objects,and the patients were divided into control group(n=30)and control group(n=30)according to random number table method.In the observation group(n=30),the former was treated with double-J tube catheterization under ureteroscopy,and the latter was treated with Huayu Tonglin decoction on the basis of the former treatment.The treatment effect of ureteral injury,TCM syndrome scores,and serum interleukin levels were compared between the two groups.(IL)-6,IL-8 and tumor necrosis factor(TNF-α),epidermal growth factor(EGF),transforming growth factor(TGF-β)-1,keratinization growth factor(KGF),cystatin(Cys-C),blood urea nitrogen(BUN)and creatinine(Scr)levels.Results:Except for 1 patient in the control group who failed to insert the tube,the other patients were successfully placed with a double J tube under ureteroscopy.Postoperative CTU examination showed that the continuity of the ipsilateral urinary tract was restored and the ureter was unobstructed.There was no significant difference in the effective rate of TCM curative effect between the observation group and the control group(P>0.05).After treatment,the scores of hematuria,low back pain and urine leakage in the observation group were lower than those in the control group,and the levels of serum IL-6,IL-8,TNF-α,EGF,TGF-β1,KGF,Cys-C,BUN and Scr were lower than those in the control group,the differences are statistically significant.Conclusion:Huayu Tonglin decoction combined with double J tube catheterization under ureteroscopy has a better therapeutic effect on ureteral injury caused by pelvic tumor surgery,can effectively improve the symptoms of patients,and better repair the damaged ureter.