三种临床辅助检查对子宫颈癌患者尿路梗阻的价值探讨  

Value of Three Clinical Auxiliary Examination for the Detection of Urinary Tract Obstruction for Cervical Cancer

作　　者：石宇[1] 谢瑞梦[1] 宋水勤[1] 徐世强[1] 樊英[1] 张国楠[1] 

机构地区：[1]四川省肿瘤医院妇瘤科,成都610041

出　　处：《肿瘤预防与治疗》2012年第2期77-81,共5页Journal of Cancer Control And Treatment

摘　　要：目的:使用三种临床辅助检查方法对宫颈癌患者输尿管梗阻状况进行探讨。方法:收集我院1995年1月至2010年12月诊断明确的宫颈癌初治患者5 153例,在治疗前常规进行放射性同位素肾图、盆腹腔多普勒彩超及血清肾功能检查,了解患者输尿管梗阻和肾功能受损情况。结果:5 153例患者中,肾图检查异常1394例(27.05%)。Ⅰa～Ⅱa期共438例,其中仅有23例肾图检查异常,无1例盆腹腔彩超和肾功能检测异常,其中术后病理证实有11例宫旁组织癌转移。Ⅱb期1 881例,肾图轻度异常352例(18.71%),有71例盆腹腔彩超异常,无1例肾功能检测异常;经新辅助化疗后128例达到手术条件,但肾图仍然轻度异常,15例术后病理证实宫旁组织有癌浸润。Ⅲa期至IVb期2 834例,肾图检查异常1 019例(35.96%),盆腹腔彩超异常,382例(13.48%),肾功能检测异常90例(3.18%)。在肾图中度～重度异常433例中,盆腹腔彩超异常382例和90例肾功能检测异常的患者均在此阶段。经统计学分析肾图,彩超、肾功能检测的结果,三者间比较差异有统计学意义(P<0.001),在提示输尿管梗阻以及肾功能受损的可能性时,肾图最敏感,肾功能检测最不敏感。结论:肾图可较敏感地发现宫颈癌患者的输尿管梗阻,而提示宫旁有可能受侵。[Abstract] Objective： To study the value of three clinical auxiliary examination for the detection of urinary tract obstruction for cervical cancer. Methods： 5 153 cervical cancer patients initially treated in our hospital from Jan 1995 to Dec 2010 were involved in our study. Radioisotope renography examination, color Doppler for the pelvis and abdomen , and serum renal function examinationwere routinely performed before treatment in order to know the situation of the ureteral obstruction and the impairment of renal function. Results： Of the 5 153 patients, 1 394 （27.05 % ） patients were found with abnormal renogram. 23 patients had abnormal renogram results among the 438 patients with stage Ⅰa - Ⅱa disease, but no one had abnormal kidney function and B-us result . Parametrial inva- sions were confirmed pathologically in 11 patients after operation. Among the 1 881patients in stage lib, 352（ 18. 7% ） had mildly ab-normal renogram results, 71 got abnormal color Doppler results, no one had abnormal kidney function results. 128 patients were operable after accepting neoadjuvant chemotherapy. But they also had mildly abnormal renogram results and 15 patients had parametrial in- vasion confirmed pathologically after operation. 1 019 （35.96%） patients had abnormal renogram results among 2 834 stage III a ~ IV bpatients, 382（ 13.48% ） patients got abnormal color Doppler results and 90（3.18% ） patients had abnormal kidney function. 433 pa- tients had moderate and severe abnormal renogram results. The 381 cases with abnormal color Doppler results and 90 eases with abnormal kidney function all got the moderate or severe abnormal renogram results. There was significant difference among these three clini-cal auxiliary examinations in detection the urinary tract obstruction for cervical cancer（P 〈 O. 001 ）. The renogram was the most sensi- tive and the kidney function test was the most insensitive way to detect the possibility of the ureteral obstruction and the impairment ofthe renal funct

关 键 词：宫颈癌 放射性同位素肾图 多普勒彩超 肾功能 输尿管梗阻 

分 类 号：R737.33[医药卫生—肿瘤]