肿瘤浸润或转移致输尿管梗阻性肾功能衰竭的处理

目的探讨由于肿瘤浸润或转移至后腹膜压迫输尿管引起的梗阻性肾功能衰竭的处理方法。方法报告25例此种患者的临床资料,原发灶为消化道肿瘤11例,泌尿生殖系肿瘤等13例,原发灶不明1例。采用CT扫描明确输尿管梗阻部位12例,MRU扫描5例,B超检查12例,IVU检查6例;并且明确肿瘤转移与梗阻的关系。采用双J导管内引流9例,输尿管皮肤造瘘10例,肾造瘘术6例。结果15例经治疗后肾功能完全恢复正常,10例肾功能有改善。结论CT扫描和MRU对于梗阻部位定位准确且无创;采用双J导管内引流和造瘘外引流损伤小,简便而效果好。

Imaging diagnosis and treatment of renal function failure secondary to ureteral obstruction by metastasis and infiltration of tumor

Objective:In order to evaluate the clinical diagnosis and the treatment of the patients with renal function failure secondary to malignant ureteral obstruction.Methods:The experiences of the management of 25 cases were reported with renal function failure secondary to malignant ureteral obstruction, of which 11 were enteron, 2 bladder, 4 prostate, 4 cervix and ovary, 1 testicle, 1 lung, 1 breast and 1 no clear. The obstructive positions were found 5 at the upper ureter, 3 at the middle ureter, 17 at the lower ureter. 12 CT scan, 5 MRU, 12 ultrasound, 6 IVU to evaluate the obstructive position and relation with tumor. The treatment included retrograde stenting in 9 patients, cutaneous ureterostomy in 10 patients, nephrostomy in 6 patients.Results:15 renal function return to normal, 10 renal function improve.Conclusions:It is considered that CT scan and MRU are better than other tests for diagnosis of obstructive position, and notraumatic. Retrograde double J stenting and nephrostomy are recommended as good methods to treat this disease, they are less traumatic, easily and perfect.