晚期宫颈癌伴上尿路梗阻19例分析

目的:探讨宫颈癌伴上尿路梗阻的治疗方法。方法:19例宫颈癌伴输尿管梗阻患者,首诊9例,宫颈癌根治术后10例,肾功能不全者11例。膀胱镜下留置双J管9例,输尿管皮肤造瘘5例,经皮肾穿刺造瘘1例,输尿管膀胱吻合1例,放弃治疗3例。结果:3例放弃治疗者,2例于2月、4月后死于肾衰。留置双J管者6例,于9~24月死于肿瘤转移,6例输尿管及肾脏造瘘者,5例于9~18月死于肿瘤转移。所有积极治疗者,肾功能明显改善。结论:宫颈癌伴输尿管梗阻患者,首选膀胱镜下留置双J管引流,失败者,根据不同情况,制定适宜的治疗方案。

Clinical analysis of 19 cases of upper ureteral obstruction with advanced cervical carcinoma

Objective:To investigate the proper treatment of upper urethral obstruction with cervical cancer.Methods:19 cases with ureteral obstruction with cervical cancer were included,9 cases without previous treatment,10 cases with cervical cancer after radical correction,11 cases with renal inadequacy.Endoscopic internal stent drainage was tried for 9 cases,5 cases received bilateral ureterostomsis.1 case received unilateral transcutaneous nephrostomy.1 case received ureterocystanastomosis and 3 cases given up therapy.Results:2 of the 3 cases who given up therapy died from renal failure after 2~4 months.The 6 cases who were sent drainage died from the metastatic carcinoma in 9~24 months.In the 6 cases who were received bilateral ureterostomsis and unilateral transcutaneous nephrostomy,5 cases died from the metastatic carcinoma in 9~18 months..The renal function were improved remarkable in the cases treated with active therapy.Conclusion:Endoscopic internal stent drainage is the choice treatment for the patients with ureter obstruction with cervical cancer.If failed,should treat properly according to different condition.