中国肿瘤临床
中國腫瘤臨床
중국종류림상
CHINESE JOURNAL OF CLINICAL ONCOLOGY
2013年
15期
923-925
,共3页
宫颈癌%输尿管梗阻%输尿管置管%放射治疗%预后
宮頸癌%輸尿管梗阻%輸尿管置管%放射治療%預後
궁경암%수뇨관경조%수뇨관치관%방사치료%예후
cervical cancer%ureteral obstruction%ureteral stents%radiotherapy%prognosis
目的：分析晚期宫颈癌并发双侧输尿管梗阻的预后因素，探讨其治疗意义。方法：通过肾图、CT、肾功能检查诊断晚期宫颈癌并发双侧输尿管梗阻患者40例，膀胱镜下输尿管逆行置管内引流13例，经皮肾穿刺输尿管顺行置管内引流25例、外引流2例，肾功能恢复正常后行放射治疗29例，对比研究输尿管导管置入前是否接受过治疗、肾功能是否正常，置管后是否接受放疗三种因素对预后的影响。结果：输尿管导管置入后肾功能恢复正常率为91.3%（21/23）。未治疗组、术后和放疗后复发组中位生存时间分别为27、15、10个月（χ2=9.379，P=0.009）。置管后接受放疗组与未行放疗组中位生存时间分别为25、9个月（χ2=17.329，P<0.001），置管前肾功能是否正常对预后影响无显著性差异（χ2=1.37，P=0.242）。结论：对于初治或术后复发的宫颈癌并发双侧输尿管梗阻患者，在解除输尿管梗阻后，应接受放射治疗，可获得较好疗效。
目的：分析晚期宮頸癌併髮雙側輸尿管梗阻的預後因素，探討其治療意義。方法：通過腎圖、CT、腎功能檢查診斷晚期宮頸癌併髮雙側輸尿管梗阻患者40例，膀胱鏡下輸尿管逆行置管內引流13例，經皮腎穿刺輸尿管順行置管內引流25例、外引流2例，腎功能恢複正常後行放射治療29例，對比研究輸尿管導管置入前是否接受過治療、腎功能是否正常，置管後是否接受放療三種因素對預後的影響。結果：輸尿管導管置入後腎功能恢複正常率為91.3%（21/23）。未治療組、術後和放療後複髮組中位生存時間分彆為27、15、10箇月（χ2=9.379，P=0.009）。置管後接受放療組與未行放療組中位生存時間分彆為25、9箇月（χ2=17.329，P<0.001），置管前腎功能是否正常對預後影響無顯著性差異（χ2=1.37，P=0.242）。結論：對于初治或術後複髮的宮頸癌併髮雙側輸尿管梗阻患者，在解除輸尿管梗阻後，應接受放射治療，可穫得較好療效。
목적：분석만기궁경암병발쌍측수뇨관경조적예후인소，탐토기치료의의。방법：통과신도、CT、신공능검사진단만기궁경암병발쌍측수뇨관경조환자40례，방광경하수뇨관역행치관내인류13례，경피신천자수뇨관순행치관내인류25례、외인류2례，신공능회복정상후행방사치료29례，대비연구수뇨관도관치입전시부접수과치료、신공능시부정상，치관후시부접수방료삼충인소대예후적영향。결과：수뇨관도관치입후신공능회복정상솔위91.3%（21/23）。미치료조、술후화방료후복발조중위생존시간분별위27、15、10개월（χ2=9.379，P=0.009）。치관후접수방료조여미행방료조중위생존시간분별위25、9개월（χ2=17.329，P<0.001），치관전신공능시부정상대예후영향무현저성차이（χ2=1.37，P=0.242）。결론：대우초치혹술후복발적궁경암병발쌍측수뇨관경조환자，재해제수뇨관경조후，응접수방사치료，가획득교호료효。
Objective:This study aimed to analyze the prognostic factor of bilateral hydronephrosis caused by advanced cervical cancer and evaluate its value of treatment. Methods:A total of 40 patients with bilateral ureteral obstruction secondary to cervical cancer were diagnosed through computerized tomography, radioactive nephrogram, and blood tests for renal function. The placement of retrograde internal double-J ureteral stents was performed under a cystoscope in 13 patients. The placement of antegrade internal double-J ureteral stents via percutaneous nephrostomy was performed in 25 patients. Two cases had external ureteral stents via percutaneous nephrostomy. Twenty-nine patients underwent radiotherapy after normalization of their blood urine nitrogen and creatinine levels. The prognostic value of the treatment and renal function before placement of ureteral stents and radiotherapy after placement of ureteral stents were analyzed. Results:The normalization rate of renal function after ureteral stenting was 91.3%(21/23). The median survival time was longer in patients with untreated cervical cancer than that in patients with recurrent cervical cancer (χ2=9.379, P=0.009). After ureteral stenting, the median survival time was longer in patients who underwent radiation therapy than that in patients untreated with radiation (χ2=17.329, P=0.000). The median survival time was not significantly influenced by renal function before placement of ureteral stents (χ2=1.37, P=0.242). Conclusion:The patient with bilateral ureteral obstruction from untreated cervical cancer or from recurrent pelvic disease after surgical therapy should be considered for ureteral stenting followed by appropriate radiation.
