超声引导下经皮肾穿刺造瘘术治疗晚期结直肠癌致梗阻性肾积水的疗效观察  

Efficacy of ultrasound-guided percutaneous nephrostomy for obstructive hydronephrosis caused by advanced colorectal cancer

作　　者：孙安毅[1] 陈晓林 陈庆 SUN An-yi;CHEN Xiao-lin;CHEN Qing(Department of Ultrasound,Quanzhou First Hospital,Quanzhou 362000,China;Department of Urologic Surgery,Quanzhou First Hospital,Quanzhou 362000,China)

机构地区：[1]福建省泉州市第一医院超声科,泉州362000 [2]福建省泉州市第一医院泌尿外科,泉州362000

出　　处：《中国肿瘤临床与康复》2021年第3期321-324,共4页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的探讨超声引导下经皮肾穿刺造瘘术治疗晚期结直肠癌致梗阻性肾积水的临床效果及对肾功能的作用。方法选取2016年8月至2019年6月间泉州市第一医院收治的72例晚期结直肠癌致梗阻性肾积水患者,采用随机数字表法分为观察组和对照组,每组36例。对照组患者采用传统经皮肾穿刺造瘘术,观察组患者采用超声引导下经皮肾穿刺造瘘术,比较两组患者的临床疗效与肾功能变化。结果所有患者均一次穿刺成功,观察组患者手术时间、术中出血量、术后造瘘管拔除时间和术后住院时间均短于对照组,差异均有统计学意义(均P<0.05)。术后1个月,观察组患者出血、感染、堵管和脱管等情况发生率为5.6%,低于对照组的30.6%,差异有统计学意义(P<0.05)。术后1个月,两组患者血清肌酐和尿素氮值均较术前降低,且观察组低于对照组,差异有统计学意义(P<0.05)。术后随访1年,观察组患者复发率为2.8%(1例),低于对照组的19.4%(7例),差异有统计学意义(P<0.05)。结论超声引导下经皮肾穿刺造瘘术治疗晚期结直肠癌致梗阻性肾积水患者,能降低患者并发症和复发率,改善肾功能,促进术后康复。Objective To investigate the efficacy of ultrasound-guided percutaneous nephrolithotomy for obstructive hydronephrosis caused by advanced colorectal cancer and its effect on renal function.Methods Seventy-two patients with obstructive hydronephrosis caused by advanced colorectal cancer at Quanzhou First Hospital from August 2016 to June 2019 were selected as the research subjects.They were randomly divided into an observation group and a control group with 36 patients in each group.The observation group underwent ultrasound-guided percutaneous nephrostomy and the control group underwent traditional percutaneous nephrostomy.Clinical efficacy and changes in kidney function were compared between the two groups.Results All patients achieved puncture after one-time trial.The duration of operation,intraoperative blood loss,time to postoperative fistula removal and postoperative length of hospital stay were shorter in the observation group than in the control group(all P<0.05).At 1 month after the operation,the incidence of complications including bleeding,infection,tube blockage and tube removal was 5.6%in the observation group,which was lower than 30.6%of the control group(P<0.05).The serum creatinine and urea nitrogen values in the two groups were decreased,and the observation group was lower than the control group(P<0.05).The recurrence rate was 2.8%(1 patient)in the observation group which was lower than 19.4%(7 patients)of the control group(P<0.05).Conclusion Ultrasound guided percutaneous nephrostomy in the treatment of obstructive hydronephrosis caused by advanced colorectal cancer can pro-mote the rehabilitation,reduce the incidence of complications and recurrence and effectively improve renal function and promote postoperative recovery.

关 键 词：超声 经皮肾穿刺造瘘术 结直肠肿瘤 梗阻性肾积水 肾功能 

分 类 号：R735.3[医药卫生—肿瘤]