摘要
目的:提高肾盂输尿管癌的诊治水平。方法:回顾性分析我院自2000年1月～2008年3月收治的45例原发性肾盂输尿管癌患者的临床资料。结果:临床表现有血尿40例,腰痛8例,体检发现肾积水1例。阳性率较高的检查有逆行尿路造影、CT、MRI和输尿管镜检查,阳性率分别为66.7%(8/12)、78.8%(26/33)、90.0%(9/10)和90.0%(9/10)。35例(87.5%)做了肾输尿管全长切除、膀胱袖状切除术。35人(77.8%)得到随访,10例在术后13(5～33)个月内14次发生膀胱肿瘤,1例输尿管癌术后3.5年发现对侧肾盂癌,14例死于癌转移,5年总体生存率为34.3%(12/35)。结论:对反复出现的肉眼血尿、腰痛和肾积水患者要考虑本病的可能,联合应用几种检查方法是提高诊断率的关键,肾输尿管全切、膀胱袖状切除术是主要治疗方法。
Objective：To improve diagnosis and treatment of primary renal pelvic and ureteral carcinoma. Methods：Retrospective analysis of 45 clinical cases of primary ureteral carcinoma patients with renal pelvis from January 2000 to March 2008. Results： Hematuria, Flank pain and hydronephrosis accounted for 40/45, 8/45 and 1/45 , respectively. The most useful methods of detecting the carcinoma preoperatively were retrograde urogram, CT, MRI and ureteroseopy, with positive percentage of 66.7% （8/12）, 78.8% （26/33）, 90.0% （9/10）, 90.0% （9/ 10） respectively. Total nephrouretereetomy with a cuff of bladder was carried out in 35（87.5 %） patients. Thirtyfive（77.8%） cases were followed up, The subsequent bladder carcinoma occurred 14 times in all 10 cases during a mean 13 months（from 5 to 33）, and the subsequent eontralateral renal pelvic carcinoma occurred in 1 case with ureteral carcinoma 3.5 years after operation. Among them, 14 died of metastasis and 21 survived. The 5 year sur viral rate were 34.3% （12/35）. Conclusions： Repeated hematuria, lumbar pain and hydronephrosis in the patients must be paid attention to. Combination of several detecting methods was the key points for the early diagnosis of renal pelvic and ureteral carcinoma. Nephrouretereetomy with a cuff of bladder was better choice of treatment.
出处
《临床泌尿外科杂志》
北大核心
2010年第7期539-541,共3页
Journal of Clinical Urology
关键词
肾盂肿瘤
输尿管肿瘤
诊断
治疗
renal pelvic carcinoma
uretera[ carcinoma
diagnosis
treatment
