摘要
目的:研究临床因素对膀胱镜下输尿管支架管置入术和肾穿刺造瘘引流术治疗宫颈癌肾积水的影响,并分析两种方法的疗效和并发症。方法:回顾性分析2008年10月~2014年10月延安大学附属医院收治的93例宫颈癌合并中重度肾积水患者,其中51例患者行膀胱镜下输尿管支架管置入术,42例患者行肾穿刺造瘘引流术。结果:两种手术方式均能安全、有效地改善患者的肾功能。输尿管支架管置入成功率与是否单侧肾积水、输尿管梗阻段长度及体力状态有显著相关性,输尿管支架管置入术后腰痛、腰困、泌尿系感染、肾皮质萎缩发生率均高于肾造瘘术。结论:膀胱镜下输尿管支架管置入术和肾穿刺造瘘引流术均可明显改善宫颈癌肾积水患者的肾功能,并发症发生率均较低。单侧肾积水、输尿管梗阻长度≤3cm和体力状态评分>60分的患者膀胱镜下输尿管支架管置入术成功率高。
Objective：To study the clinical factors on urinary diversion by percutaneous nephrostomy drainage or ureteral stenting for hydronephrosis in patients with cervical cancer,and compare the difference in efficacy and complications between the two methods.Method：We retrospectively analyzed the data of 93 patients with moderately to severe hydronephrosis from October 2008 to October 2014 in Yan＇an University affiliated hospital.Fiftyone patients were performed endoscopic ureteral stent insertion,and other 42 patients underwent ultrasoundguided percutaneous nephrostomy drainage.Result：Both endoscopic ureteral stent insertion and ultrasound-guided percutaneous nephrostomy drainage were safe and effective.The success rate of endoscopic ureteral stent insertion was correlated with unilateral hydronephrosis,ureteral obstruction length and performance status.The rate of postoperative complications such as backaches,urinary tract infections and collapse of cortical areas was higher in patients undergoing endoscopic ureteral stent insertion.Conclusion：Both percutaneous nephrostomy and ureteral stenting can improve kidney function of the patients with hydronephrosis caused by cervical cancer.Complication rates are low in these two groups.The success rate of ureteral stenting is significantly associated with unilateral hydronephrosis,ureteral obstruction length ≤3cm and performance status〉scores 60.
出处
《临床泌尿外科杂志》
2017年第4期298-302,共5页
Journal of Clinical Urology
关键词
肾积水
宫颈癌
输尿管支架管
肾穿刺造瘘
hydronephrosis
cervical cancer
ureteral stent
percutaneous nephrostomy
