输尿管导管在复杂盆腔肿瘤手术中预防输尿管损伤的应用

摘要

Objective To investigate the clinical value and adverse reactions of indwelling ureteral stentsinthepreventionofureteralinjurybeforecomplexpelvictumorsurgery.Methods 145casesofpatients with rectal cancer ,cervical cancer ,ovarian cancer and pelvic sarcomas were retrospectively analyzed ,and 53 pa-tients with complex pelvic tumor surgery ,preoperative were under cystoscope unilateral or bilateral ureteral stent tube,pulled out according to the intraoperative situation after surgery or lien ,92 patients as control group .Results Ureteral injury was found in 10 of the 145 patients,2 cases in ureteral catheter group and 8 cases in control group .3 cases of postoperative ureteral fistula occurred in the control group .Indwelling ureteral stents could cause adverse reactions such as hematuria ,osphyalgia and urinary irritation ,and the adverse reactions of catheter group was obviously higher than that of control group (P<0.05).Conclusion Cystoscopic ureteral stent placement has important clinical significance for prevention of ureteral injury despite certain adverse reactions ,which can be used in operation of complex pelvic tumor .%目的：探讨在复杂盆腔肿瘤手术前留置输尿管导管预防输尿管损伤的临床应用和不良反应。方法回顾性分析直肠癌、宫颈癌、卵巢癌、盆腔肉瘤等盆腔复杂肿瘤手术患者145例，其中92例患者术前未放置导管（对照组），53例患者术前在膀胱镜下留置单侧或双侧输尿管导管（置管组），术后根据术中情况拔出或留置。结果145例患者中10例术中发生输尿管损伤，其中置管组2例，对照组8例；术后输尿管瘘3例均发生在对照组；留置输尿管导管可引起血尿、下尿路刺激症状、腰痛等不良反应，且置管组的不良反应明显高于对照组（P＜0．05）。结论复杂盆腔肿瘤术前经膀胱镜留置输尿管导管有助于术中分离和保护输尿管，对于预防输尿管损伤有临床意义，但有一定的不良反应，因此应明确适应症，谨慎应用。