双“J”管在Ⅱb期宫颈鳞癌手术中的应用  

The use of double ‘J’ tube in the operation of cervical squamous carcinoma with stage Ⅱb.

作　　者：王天成[1] 殷红 唐秀英 

机构地区：[1]河南省漯河市中心医院妇一科,漯河462000 [2]湖北省武汉市新华医院 [3]湖南省岳阳市第一人民医院泌尿外科

出　　处：《中华妇幼临床医学杂志（电子版）》2006年第4期203-205,共3页Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition)

摘　　要：目的探讨双“J”管在Ⅱb期宫颈鳞癌手术中对输尿管的作用。方法对17例Ⅱb期宫颈鳞癌患者(观察组),经膀胱或经腹腔双侧输尿管置入双“J”管,行子宫广泛切除术+盆腔淋巴清扫术,术后X射线检查双“J”管;术后3个月时,X射线复查双“J”管,在膀胱镜下拔除。19例Ⅱb期宫颈鳞癌患者(对照组),在不使用双“J”管下行子宫广泛切除术+盆腔淋巴清扫术。对两组进行术中、术后对照研究。结果观察组手术达标率为76.47%(13/17),明显高于对照组的52.63%(10/19),差异有显著意义(P<0.05)。观察组中无输尿管损伤、尿瘘发生。对照组有3例输尿管损伤(P<0.01),1例输尿管阴道瘘。观察组术后发生输尿管痉挛、血尿、发热等较对照组高(P<0.01)。术后3个月拔除双“J”管时,观察组17例均顺利。随访,观察组2例死亡(非尿毒症)。对照组1例死亡(合并尿毒症)。结论Ⅱb期宫颈鳞癌使用双“J”管,能有效预防术中、术后对输尿管的损伤和压迫,维持输尿管通畅,提高手术达标率,降低手术不良反应。Objective To investigate the role of ureter of double ＇J＇ tube in the operation of cervical squamous carcinoma with stage Ⅱb. Methods 17 cases with cervical squamous carcinoma of stage Ⅱb （investigational group） were treated with hysterectomy and clearance of pelvic lymph nodes, after double ＇J＇ tube was placed through bladder or abdominal cavity. After operation the double ＇J＇ tube was examined with x-rays. After three months the double ＇J＇ tube was removed through cystoscope. 19 cases with cervical squamous carcinoma of stage Ⅱb （ control group） were treated with hysterectomy and clearance of pelvic lymph nodes alone. Results The excision rates of investigational group and control group were 76. 47% and 52. 63% ,respectively（P〈0. 05）. No ureteral damage and fistula was found in the investigational group, and control group 3 cases ureteral damage were found and 1 case occurred uretervagina fistula after operation. The incidence of ureteral spasm, hematuresis and fever were higher in investigational group（P〈0.01）. After three months, the double ＇J＇ tube was removed successfully in 17 cases. 2 cases died in the following in the investigational group, but no uremia occurred. 1 case died of uremia in control group. Conclusion It can prevent ureteral damage and oppression, keep ureters unobstructed, improve the excising incidence and decrease the operational side effect to use double ＇J＇ tube in the operation of cervical carcinoma with stage Ⅱb.

关 键 词：宫颈癌 双“J”管 手术 输尿管 

分 类 号：R737.33[医药卫生—肿瘤]