恶性肿瘤继发输尿管狭窄的超声引导经皮穿刺顺行输尿管支架管置入治疗  

Percutaneous Puncture Ultrasound-guided of Ureteral Stent for the Treatment of Ureteric Stenosis Due to Malignant Tumor

作　　者：于友涛[1] 陈辉[2] 杨光[1] 李陆鹏[1] 张晶岩[1] 何东风[1] 

机构地区：[1]哈尔滨医科大学附属第三医院介入科,哈尔滨150040 [2]哈尔滨医科大学附属第三医院泌尿外科

出　　处：《临床泌尿外科杂志》2011年第10期738-740,共3页Journal of Clinical Urology

摘　　要：目的:探讨超声引导经皮穿刺顺行输尿管支架管置入术治疗恶性肿瘤引起的输尿管狭窄导致的肾功能衰竭的应用价值及安全性。方法:对11例患者经超声引导下行双侧肾盂穿刺,透视下双侧顺行放置输尿管支架管,术后观察肾功能恢复情况。结果:11例共22只输尿管支架管置放术均一次成功,无严重并发症出现。术后1周血肌酐、尿素氮恢复正常。术后经肾脏超声、CT随访检查,肾盂、输尿管扩张积水均消失,患者腰痛症状消失。术后生存时间4～12个月,平均5个月,患者最终因肿瘤进展而死亡。结论:超声引导经皮穿刺顺行输尿管支架管置入术,治疗原发或转移性恶性肿瘤引起的输尿管狭窄导致的肾功能衰竭安全可靠、并发症少,可有效延长患者的生存期,改善生存质量。Objective：To evaluate the therapeutic value and ture antegrade placement of ureteral stent for the treatment of PCN was done in 11 cases of acute malignant obstructive renal safety of the Ultrasound-guided percutaneous punc the renal failure. Method： Ultrasonic guide bilateral failure resulting from bilateral ureteral obstruction. After examining the size, growth direction and length of the pathological change with the 3-Dimensional digital subtraction, the bilateral antegrade ureteral stent placement was attempted fluoroscopicviewingly. The recovery of renal function was observed after the operation. Result： 22 procedures were all successful in the first attempt. No other serious complications occurred. A week after the treatment the serum creatinine and urea levels returned to normal. Through the renal ultrasonography and CT follow-up examination, we found the hydornephrosis, hydroure- terectasis and lumbago symptom of the above 11 patients disappeared after the treatment. The survival time of the 11 patients after operation is 4 months to 12 months averaging 5 months. Eventually,the patients died due to their tumor progression. Conclusion：The image guide percutaneous puncture antegrade placement of ureteral stent in the management of renal failure resulting from the primary of metastatic malignant tumors ureteral obstruction is safe, reliable and less complications. Furthermore,it can provide the prolongation of patients＇ survival span and improve the living quality of patients.

关 键 词：超声引导 恶性肿瘤 输尿管狭窄 肾功能衰竭 输尿管支架管 

分 类 号：R693[医药卫生—泌尿科学]