直肠癌放疗中膀胱容积测量仪保持膀胱充盈度可行性探讨

目的 探讨利用膀胱容积测量仪使直肠癌患者放疗实施过程中保持膀胱充盈度一致的可行性。方法 用膀胱容积测量仪测量患者尿量并记录，然后排空尿液，利用量杯测量尿液量，验证其可靠性。42例患者计划CT的膀胱容积作为标准尿量，每天在放疗前使用膀胱容积测量仪监测膀胱容积，测量患者主诉“尿急”时的膀胱容积(主诉尿量)、通过干预到达标准尿量(控制尿量)，观察尿量变化。采用t检验及Pearson相关分析。结果 使用膀胱容积测量仪测量膀胱尿量与放疗计划进行比较，两者测量值基本保持一致(P=0.84)。实测尿量与膀胱容积测量仪测量尿量明显相关性(P=0.00)。患者的憋尿能力逐渐性下降，控制尿量从第1、2、3、4、5周分别下降5%、6%、6%、4%、11%，主诉尿量分别下降21%、20%、20%、21%、26%(P=0.00)。结论 患者膀胱尿量在治疗过程中呈下降趋势，膀胱容积测量仪干预下膀胱容量接近计划时水平，从而能保持膀胱稳定的充盈度。

Feasibility of keeping the consistency of bladder filling by a Bladderscan device during radiotherapy for rectal cancer

Objective To evaluate the feasibility of keeping the consistency of bladder filing by a Bladderscan (BS) device during radiotherapy for rectal cancer. Methods The bladder volume was measured using a BS device and recorded. To verify the reliability of the BS measurement, the urinary output was determined by a measuring glass after complete urinary discharge. The bladder volume of 42 patients determined by the planning computed tomography (CT) scans was used as the standard urinary volume. The bladder volume was measured using the BS device before radiotherapy every day. The chief complaint urinary volume was determined as the bladder volume when a patient felt a strong urge to urinate. The controlled urinary volume was determined as the urinary output intervened by the BS device to reach the standard urinary volume. Comparison was made by t test and data was assessed by Pearson correlation analysis. Results There was no significant difference in obtained urinary volume between the BS device and the planning CT scan (P=0.84). The urinary volume measured by the measuring glass was correlated with that measured by the BS device (P=0.00). The ability to hold urine in all patients was gradually weakened during treatment. The controlled urinary volume had a significantly smaller decrease after 1, 2, 3, 4, and 5 weeks of treatment than the chief complaint urinary volume (5% vs. 21%;6% vs. 20%;6% vs. 20%, 4% vs. 21%;11% vs. 26%;all P=0.00). Conclusions Patients have a gradually decreased urinary volume during treatment. The intervention by the BS device gives a bladder volume close to that in the planning system, which results in a consistent bladder filling.