宫颈癌术后辅助治疗患者留置双J管的相关临床研究

Indwelling double J stents in reducing urinary tract complications in patients undergoing postoperative radiotherapy after cervical cancer surgery

  • 摘要: 目的 探讨宫颈癌术后辅助治疗患者留置双J管的临床意义。 方法 选取本院2013年6月- 2016年6月宫颈癌ⅠA -ⅡA期病例,所有患者均接受宫颈癌根治术且术后行辅助治疗(放疗或放化疗),分为观察组(留置双J管组)和对照组(常规治疗组),均行术后辅助放疗(或放化疗),比较两组肾功能和并发症情况。 结果 观察组39例,对照组42例。两组在平均年龄、体质量指数、治疗前肌酐值、尿素氮值、FIGO分期、病理类型以及联合化疗构成上差异无统计学意义(P均> 0.05)。观察组肾积水总发生率10.3%(4例) vs 33.3%(14例)和轻度肾积水发生率5.1%(2例) vs 21.4%(9例)少于对照组(P均< 0.05);两组中度和重度肾积水发生率差异无统计学意义(P均> 0.05);观察组肌酐(116.9±43.0)μmol/L vs (170.8±68.4)μmol/L,P< 0.001和尿素氮(5.4±1.9) mmol/L vs (7.7±2.5) mmol/L,P< 0.001均低于对照组。观察组留置双J管期间发热15.4%(6例) vs 11.9%(5例)、感染23.1%(9例) vs 9.5%(4例)、腰痛30.8%(12例) vs 19.0%(8例)、肾区叩击痛20.5%(8例) vs 14.3%6例)和放射性膀胱炎33.3%(13例) vs 23.8%(10例)发生率与对照组差异无统计学意义(P均> 0.05)。 结论 宫颈癌术后辅助治疗患者留置双J管能够降低输尿管梗阻发生率,保护肾功能,具有重要临床价值。

     

    Abstract: Objective To analyze the value of double J stent in patients undergoing postoperative radiotherapy after cervical cancer surgery. Methods All patients with cervical cancer (stage Ⅰ A & Ⅱ A & Ⅱ B) who underwent cervical cancer surgery in our hospital from June 2013 to June 2016 and treated with postoperative radiotherapy were divided into observation group (indwelling double J stent group, n=39) and control group (conventional treatment group, n=42). The renal function and complications of the two groups were recorded and compared. Results There was no significant difference between the two groups in mean age, body mass index, FIGO clinical stage, pathological type and combined chemotherapy (All P> 0.05). In the observation group, the total incidences of hydronephrosis 4 cases (10.3%) vs 14 cases (33.3%) and mild renal hydrocephalus 2 case (5.1%) vs 9 cases (21.4%) were significantly lower than those in the control group (All P< 0.05). The creatinine (116.9±43.0 μmol/L vs 170.8±68.4 μmol/L, P< 0.001) and urea nitrogen (5.4±1.9 mmol/L vs 7.7±2.5 mmol/L, P< 0.001) in the observation group were also lower than those in the control group. During the indwelling of the double J stent, the incidences of fever, infection, lumbago, kidney area percussion pain and radiation cystitis in the observation group were not significantly different compared with those of the control group (All P> 0.05). Conclusion It is an effective, safe and feasible method to prevent ureteral obstruction and protect renal function by indwelling double J stent in patients undergoing radiotherapy after cervical cancer surgery.

     

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