宫颈癌放射性同位素肾图检查的临床意义探讨  

Clinical significance of radioactive nephrogram in cervical cancer patients

作　　者：唐国民[1] 宋水勤[1] 张荣荣[1] 徐世强[1] 石宇[1] 樊英[1] 张国楠[1] 

机构地区：[1]四川省肿瘤医院,成都610041

出　　处：《现代妇产科进展》2006年第7期502-504,共3页Progress in Obstetrics and Gynecology

摘　　要：目的:研究宫颈癌放射性同位素肾图(肾图)检查的临床意义。方法:1995年1月至2006年3月对我院收治的2205例宫颈癌初治患者常规进行肾图检查,了解有无尿路梗阻和肾功能受损,并进行彩色多普勒超声检查和肾功能检查,比较此3种检查方法,评价其检测尿路梗阻和肾功能受损的灵敏度和临床价值。结果:2205例患者,肾图检查异常871例(39.50%);彩超检查异常293例(13.29%);肾功能检测异常61例(2·77%)。Ⅰb1期、Ⅰb2期、Ⅱa期共159例,其中13例肾图检查异常,但无1例彩超检查和肾功能检测异常;Ⅱb期969例,肾图检查正常726例(74.92%),轻度异常243例(25·90%);彩超检查异常48例(4.90%)。无1例肾功能检测异常;Ⅲb期1017例,肾图检查异常580例(57.03%),彩超检查异常224例(22.02%),肾功能检测异常56例(5·51%)。肾图中度、重度异常290例中仅56例肾功能检测异常,占19.31%。经χ2检验比较肾图,彩超、肾功能检测的结果,发现异常提示尿路梗阻以及肾功能受损的可能性,三者间比较有显著的统计学差异(P<0.001)。其中肾图最敏感,其次为彩超,肾功能检测最不敏感。结论:肾图可较灵敏地发现宫颈癌浸润是否累及输尿管并造成输尿管梗阻及肾功能受损。肾图检查的结果对宫颈癌临床分期有一定的参考价值,对治疗方案的制定也有一定的指导意义。Objective：To study the clinical significance of radioactive nephrogram in cervical cancer patients. Methods： From Jan 1995 to Mar 2006, the radioactive nep routinely performed in 2205 cervical cancer patients in Sichuan Cancer Hospital to evaluate if the patients have the urinary obstruction and impairment of the renal function. The color Doppler ultrasound examination and the blood test for renal function were also routinely performed in order to compare the sensitivity of the three tests for detecting the urinary obstruction and the impairment of the renal function. Results：Of the 2205 patients, 871 patients （39.5 % ） were found abnormal by nephrogram, 293 patients （13. 29% ） were found abnormal by Doppler,only 61 patients （2.77%） were found abnormal by blood test. Of the 159 patients staging I b1, I b2 and Ⅱ a, 13 patients were detected abnormal by nephrogram but no one was found by Doppler and blood test. Of the 969 patients staged Ⅱ b ,726 patients （74.92%） were found normal and 243 patients （25.9%） were detected slightly abnormal by nephrogram while only 48 patients （4.9%） were found abnormal by Doppler and no one by blood test. Of the 1017 patients staged Ⅲb of which 580 patients （57.03%） were detected abnormal by nephrogram and 224 patients （22.02%） by Doppler and 56 patients （5.51% ） by blood test. Of the 290.patients detected by nephrogram with middle and severe impairment of renal function only 56 patients （ 19.31% ） were found abnormal by blood test. Comparing the detecting results by X2 test we found that the three testing methods had significance in sensitivity for detecting the possibility of the urinary obstruction and the impairment of the renal function. The nephrogram is the most sensitive test then the Doppler and the blood test was the most insensitive. Conclusion：Nephrogram can be used to sensitively find out whether the cervical cancer has invaded the ureter, and whether the ureter is obstructed and the renal function is impaired. The re

关 键 词：宫颈癌 放射性同位素肾图 输尿管梗阻 

分 类 号：R737.33[医药卫生—肿瘤]