宫颈癌治疗后患者排尿异常的调查  

Investigation of Abnormal Micturition after Cervical Cancer Treatment

作　　者：陈姝宁 孔为民[1] 罗丹 王志坚 CHEN Shuning;KONG Weimin;LUO Dan;WANG Zhijian(Department of Gynecologic Oncology,Beijing Obstetrics and Gynecology Hospital,Capital Medical University,Beijing 100006,China)

机构地区：[1]首都医科大学附属北京妇产医院妇瘤科,北京100006

出　　处：《医学综述》2020年第6期1224-1227,共4页Medical Recapitulate

摘　　要：目的调查宫颈癌患者治疗后排尿异常的发生情况,为其预防和治疗提供理论依据。方法收集2006年5月至2019年3月在首都医科大学附属北京妇产医院接受治疗的宫颈癌患者的临床资料,包括患者的年龄、病理类型、国际妇产科联盟2009分期以及采用的治疗方法等,分析宫颈癌治疗后排尿异常的发生情况,并进一步分析手术后排尿异常的发生情况和放、化疗后患者排尿异常的发生情况。结果本研究共纳入患者236例,其中单纯手术治疗45例(19.1%),手术+放疗13例(5.5%),手术+同步放化疗30例(12.7%),根治性放疗10例(4.2%),同步放化疗138例(58.5%)。治疗后排尿异常的总发生率为53.4%,其中膀胱麻痹的发生率最高,为40.0%,其余依次为膀胱炎(27.5%)、尿失禁(16.1%)。手术+放疗后患者排尿异常的发生率最高,为76.9%(10/13),根治性放疗/同步放化疗后排尿异常的发生率最低,为48.0%(71/148)。随访发现,手术治疗后膀胱麻痹的发生率最高(45.5%),其余依次为尿失禁(14.8%)、膀胱炎(12.5%);放、化疗后膀胱炎的发生率最高,为33.5%,其余依次为尿失禁(15.2%)、膀胱麻痹(13.1%)。结论宫颈癌患者治疗后排尿异常的发生率较高,其中手术后膀胱麻痹的发生率较高,而放、化疗后膀胱炎的发生率较高,临床上应对此予以重视,采取必要的预防和干预措施,以期提高患者治疗后的生活质量。Objective To investigate the status of abnormal micturition in patients after cervical cancer treatment and providing theoretical basis to the prevention and treatment.Methods A total of 236 patients of cervical cancer treated in Beijing Obstetrics and Gynecology Hospital,Capital Medical University from May 2007 to Mar.2019 were included.The age,pathological type,FIGO 2009 stage and treatment regimens of patients were collected.The occurrence of abnormal micturition after cervical cancer treatment was observed,and the occurrence of abnormal micturition after operation,radiotherapy and chemotherapy.Results The 236 cases collected included 45 cases(19.1%)of surgery alone,13 cases(5.5%)of postoperative radiotherapy,30 cases(12.7%)of postoperative concurrent chemoradiotherapy,10 cases(4.2%)of radical radiotherapy,and 138 cases(58.5%)of concurrent chemoradiotherapy.Totally,the incidence of abnormal micturition after treatment was 53.4%.The incidence of cystoparalysis was the highest(40.0%),followed by cystitis(27.5%)and urinary incontinence(16.1%).The incidence of abnormal micturition was the highest(76.9%,10/13)in patients after postoperative radiotherapy,and was the lowest(48.0%,71/148)in patients after radical radiotherapy/concurrent chemoradiotherapy.During the follow-up time,it was found that after surgery the incidence of cystoparalysis was the highest(45.5%),followed by urinary incontinence(14.8%)and cystitis(12.5%);after radiotherapy and chemotherapy,the incidence of cystitis was the highest(33.5%),followed by urinary incontinence(15.2%),cystoparalysis(13.1%).Conclusion The incidence of abnormal micturition is high after cervical cancer treatment.After surgery,the incidence of cystoparalysis is higher than other abnormal micturitions;after radiotherapy and chemotherapy,the incidence of cystitis is higher than others.Attention should be paid to the occurrence of urinary micturition,and necessary prevention and intervention measures should be taken to improve the quality of life of the patients after treatment.

关 键 词：宫颈癌 排尿异常 尿失禁 膀胱麻痹 膀胱炎 

分 类 号：R737.3[医药卫生—肿瘤]