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恶性肿瘤致输尿管梗阻治疗方法的选择及疗效观察 预览 被引量:6

Clinical effectiveness of the treatments for ureteral obstruction caused by malignant tumor
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摘要 目的 探讨恶性肿瘤引起的输尿管梗阻治疗方法的选择并观察其疗效.方法 回顾性分析2011年6月至2013年12月中山大学附属第六医院泌尿外科收治的因恶性肿瘤引起的输尿管梗阻患者32例,行逆/顺行输尿管金属支架置入术或经皮肾穿刺造瘘术,分析治疗过程的临床资料.结果 32例患者均先行逆行输尿管金属支架置入手术,成功17例(53.1%),失败15例(46.9%),失败15例患者再行顺行输尿管金属支架置入手术,成功10例(66.7%),失败5例(33.3%),失败5例患者最后行经皮肾穿刺造瘘术,全部成功.所有患者治疗后临床症状明显改善,肌酐(Cr),血尿素氮(BUN)及肾盂分离值三种指标均较治疗前有显著性改善(P<0.05).经皮肾穿刺造瘘术患者慢性疼痛发生率显著高于输尿管金属支架置入术患者(P<0.05).所有患者均无严重并发症.结论 输尿管金属支架逆/顺行置入术或经皮肾穿刺造瘘术治疗恶性肿瘤引起的输尿管梗阻临床疗效满意,可根据不同情况灵活选择术式. Objective To explore the method and efficacy of internal ureteral stenting (IUS) and percutaneous nephrostomy (PCN) in treatment for ureteral obstruction caused by malignant tumor.Methods From June 2011 to December 2013,32 patients with ureteral obstruction caused by malignant tumors in the Sixth Affiliated Hospital of Sun Yat-Sen University were recruited and received PCN,retrograde IUS or antegrade IUS.Clinical data were analyzed.Results All of the 32 patients firstly received retrograde IUS,the success-rate was 53.1% (17/32).The 15 patients failed who underwent antegrade IUS,the sucess rate was 66.7% (10/15).The remaining 5 patients finally received PCN successfully.The levels of Cr/BUN and pelvis separation of all patients were significantly lower after treatment (P〉0.05) without any severe complications.The incidence of post-operation chronic pain was significantly higher in PCN than IUS (P〈0.05).Conclusion The PCN and IUS are both effective for the treatment ofureteral obstruction caused by malignant tumor.Either treatment can significantly relieve the clinical symptoms,therefore treatment should be chosen individually.
作者 瞿虎 马波 汪中扬 张靖 袁浩锋 Qu Hu, Ma Bo, Wang Zhongyang, Zhemg Jing Yuan Haofeng( Department of Urology, the Sixth Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510655, China)
出处 《中华腔镜泌尿外科杂志(电子版)》 2014年第6期41-44,共4页 Chinese Journal of Endourology(Electronic Version )
基金 基金项目:广东省科技计划项目基金(20118061300048)
关键词 输尿管梗阻 恶性肿瘤 金属支架管 治疗 Ureteral obstruction Malignant tumor Metal ureteral stent Treatment
作者简介 通讯作者:马波,Email:zslymnwk@163.com
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