盆腔肿瘤放疗中膀胱充盈一致性初步研究

目的 利用B超膀胱容量测量仪(BS)寻找简单、易行方式对盆腔肿瘤患者放疗过程中保持相对稳定尿量,在体位固定、CT扫描、计划设计、放疗实施时膀胱充盈程度保持一致的方法。方法 让2013-2014年收治的66例盆腔肿瘤放疗患者排空膀胱后立即饮水500 ml,用BS分别测量4个时间节点的膀胱容量。对放疗前62例患者进行随机分组单盲试验,排空膀胱后饮水500 ml,等待主观感觉尿急。第1组对42例患者进行口头交代憋尿,患者主诉“尿急”时进行膀胱容量测量并记录尿量。第2组告知20例患者尿量需达到计划设计时的标准,用BS监测是否达标。结果 从排空到主观感觉尿急的时间集中在0.5~1.5 h,主观感觉尿急时测得的尿量在30~500 ml。第1组主诉尿急时膀胱容量与计划设计时膀胱容量差异为30.6%。第2组膀胱容量差异为12.6%。结论 利用BS监测膀胱容量,指导患者形成稳定的尿急感受并达到与计划设计时相接近的膀胱容量,可以保持膀胱稳定的充盈程度。

Consistency of bladder filling during radiotherapy for pelvic tumor: a preliminary study

Objective To investigate a simple and easy method to maintain a stable urine volume and consistent bladder filling during immobilization,CT scanning,plan designing,and radiotherapy using an ultrasonic bladder capacity scanner (BS).Methods A total of 66 patients with pelvic tumor who were admitted to our hospital and received radiotherapy from 2013 to 2014 were enrolled and required to drink 500 ml water after emptying the bladder.BS was used to measure bladder capacity at four time points.Before radiotherapy,62 patients with pelvic tumor were randomly divided into two groups in a single-blind trial.Both groups were asked to empty the bladder,drink 500 ml water,and wait for a subjective feeling of urgency of urination.The 42 patients in group 1 were asked to hold urine,and bladder capacity was measured and urine volume was recorded when patients complained of "urgency of urination".The patients in group 2 were told that urine volume should reach the standard in plan designing,and BS was used to determine whether the standard was reached.Results The time from bladder emptying to the subjective feeling of urgency of urination ranged from 0.5 to 1.5 hours;when the patients had a subjective feeling of urgency of urination,the urine volume ranged from 30 to 500 ml.In group 1,when the patients had a subjective feeling of urgency of urination,the difference between the bladder capacity measured and that in plan designing was 30.6％,while in group 2,the difference was 12.6％.Conclusions The use of BS in monitoring bladder capacity helps patients to develop a stable feeling of urgency of urination and reach the bladder capacity in plan designing and thus maintain a consistent degree of bladder filling.