放射性膀胱炎的外科治疗体会  

Surgical treatment in the radiation induced cystits

作　　者：须霆[1] 汪仪俊[1] 杨尔火斤 

机构地区：[1]江苏省肿瘤医院普外科,江苏南京210009

出　　处：《现代医学》2004年第5期330-332,共3页Modern Medical Journal

摘　　要：目的　总结 17例接受放射性治疗后出现放射性膀胱炎患者接受不同外科治疗的体会 ,为今后处理放射性膀胱炎提供一定的参考依据。方法　 17例病例均因盆腔肿瘤放疗后出现放射性膀胱炎 ,8例予以 5 %甲醛溶液膀胱灌注 ,有 6例予以尿路引流 ,6例行尿路分流手术。结果　 5例予以 5 %甲醛溶液膀胱灌注者症状消失 ,肉眼血尿消失时间2～ 45d(平均 3 1.2d) ;6例尿路引流中 4例经治疗后肉眼血尿症状消失 ,时间为 5～ 2 1d(平均 16.7d) ;6例手术者均获成功 ,无明显术后并发症。结论　放射性膀胱炎是一种少见而较难处理的放疗后晚期并发症 ,临床医生需要根据患者的一般情况和出血情况选择治疗手段 ,在病情比较轻、出血量较少、发病相对缓慢时选择内科治疗和甲醛膀胱灌注及持续膀胱冲洗 ,以控制症状 ,如果不能控制 ,应及时手术。Objective To find out rational surgical treatment for radiotherapy induced cystitis. Methods Radioinduced cystitis occurred after completion of pelvic malignancies radiotherapy. Eight patients were received 5% formalin instillation, 6 patients were received simple bladder irrigation, and 6 patients were received uninary diversion and cystectomy. Results The time of hematuria resolved completely in 5 of 8 patients who received 5% formalin instillation was 2～45?days (mean time 31.2 days). The time of hematuria resolved completely in 4 of 6 patients who received simple bladder irrigation was 5～21?days (mean time 16.7 days). Six patients received uninary diversion and cystectomy were recovered, no complication was seen. Conclusion Radioinduced cystitis is a serious complication and relative rare event. Clinic doctors should choose medical treatment such as formalin instillation, simple bladder irrigation and uninary diversion based on the hematuria and constitution of patients.

关 键 词：放射性膀胱炎 尿路 膀胱灌注 外科治疗 肉眼血尿 体会 患者 参考依据 结论 情况 

分 类 号：R694[医药卫生—泌尿科学] R737.14[医药卫生—外科学]