| 曾永威,高婉仪,唐照方,等.双 J管联合坦索罗辛在盆腔肿瘤治疗中预防输尿管副损伤的意义[J].安徽医药,2021,25(8):1660-1663. |
| 双 J管联合坦索罗辛在盆腔肿瘤治疗中预防输尿管副损伤的意义 |
| Application of double J tube combined with tamsulosin in the prevention of ureteral injury in the treatment of pelvic tumor |
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| DOI：10.3969/j.issn.1009-6469.2021.08.043 |
| 中文关键词: 辐射损伤 双 J管 坦索罗辛 盆腔肿瘤 输尿管副损伤 |
| 英文关键词: Radiation injuries Double-J tube Tamsulosin Pelvic tumors Ureteral injury |
| 基金项目:佛山市医学类科技攻关项目( 2018AB001585) |
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| 中文摘要: |
| 目的探讨双 J管联合坦索罗辛在盆腔肿瘤治疗中预防输尿管副损伤的应用意义。方法选取 2010年 10月至 2019年 9月佛山市三水区人民医院盆腔肿瘤手术病人 404例，分为预置管组 120例，未置管组 246例，单纯口服坦索罗辛组 38例。预置管组术前膀胱镜下输尿管逆行插管留置双 J管并保留至术后盆腔放疗结束，联合口服坦索罗辛缓释胶囊；未置管组未预置双 J管；单纯口服坦索罗辛组在盆腔肿瘤手术术后单纯口服坦索罗辛缓释胶囊。比较三组临床资料、术中输尿管损伤情况及术后放疗并发症。结果预置管组术中输尿管损伤 2(1.67%)例，未置管组损伤 13(5.28%)例，两组损伤率比较，差异有统计学意义( P< 0.05)；三组术后放疗后，预置管组 89例中有 2例出现输尿管狭窄导致肾功能损伤( 2.25%)，未置管组 162例中有 22例( 13.58%)单纯口服坦索罗辛组 38例中有 6例( 15.79%)预置管组与另外两组术后放疗并发症发生率比较，均差异有统计学意义( P< 0.0，5)。结论双 J管联合坦索罗辛在盆腔肿瘤术中，对提高术中输尿管的辨识，减少术中输尿管损伤及术后输尿管纤维化狭窄，降低放射性输尿管狭窄致肾功能损伤的风险，减少术后留置双 J管尿路刺激症状，促进输尿管损伤康复，保护肾功能有重要意义。 |
| 英文摘要: |
| Objective To explore the clinical significance of double-J tube combined with tamsulosin in the prevention of ureteral injury in the treatment of pelvic tumor.Methods A total of 404 patients undergoing pelvic tumor surgery in Sanshui District People'sHospital of Foshan City from October 2010 to September 2019 were selected. The patients were assigned into preset tube group (n = 120), non-tube group (n = 246) and oral tamsulosin group (n = 38). In the preset tube group, double-J tube was indwelling through retrograde ureteral intubation under cystoscope before operation and double-J tube was retained until the end of postoperative pelvic radiotherapy, combined with oral tamsulosin sustained-release capsule. There was no double-J tube in the group without catheterization. In the tamsulosin group, tamsulosin sustained-release capsules were taken after pelvic tumor surgery. The clinical data, intraoperative ureteral injury and postoperative radiotherapy complications of the three groups were compared.Results There were 2 (1.67%) cases of ureteral injury in the preset tube group and 13 (5.28%) cases of ureteral injury in the non-catheterized group, and the difference of injury rate between the two groups was statistically significant (P < 0.05). After postoperative radiotherapy in the three groups, 2 of 89 patients (2.25%) in the preset tube group, 22 of 162 patients (13.58%) in the non-tube group, and 6 of 38 patients (15.79%) in the orallyadministered tamsulosin group developed ureteral stricture resulting in renal function impairment. The incidence of postoperative radiotherapy complications in the preset tube group was compared with that in the other two groups. The difference was statistically significant (P < 0.05).Conclusion Combined use of double-J tube tamsulosin in pelvic tumor surgery has important significance to improvethe identification of ureter, reduce ureteral injury and postoperative ureteral fibrosis stenosis, reduce the risk of renal function injury caused by radioactive ureteral stenosis, reduce the symptoms of urinary tract irritation caused by indwelling double-J tube, promote the recovery of ureteral injury, and protect renal function. |
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