以脓毒血症为首发症状的输尿管癌的临床病例分析  

Clinical Analysis of Ureteral Carcinoma with the Primary Symptom of Sepsis

作　　者：党瑞锋[1] 郭琦 王辅[1] DANG Ruifeng;GUO Qi;WANG Fu(Department of Urology,First People′s Hospital of Tianshui,Tianshui 741000,Gansu,China)

机构地区：[1]天水市第一人民医院泌尿外科,甘肃天水741000

出　　处：《系统医学》2025年第6期84-87,共4页Systems Medicine

摘　　要：目的探讨以脓毒血症为首发症状的输尿管癌的临床特点、治疗策略及预后。方法回顾性选取2022年8月—2023年10月就诊于天水市第一人民医院的3例以尿源性脓毒血症为首发表现的上尿路尿路上皮癌患者的临床资料,包括患者信息与病史、入院检查、影像学检查、术后治疗与随访。结果3例患者均以腰痛伴发热为主要症状就诊,其中1例曾在外院被误诊为输尿管狭窄,经输尿管探查明确诊断后,行根治性手术;另2例患者行一期造瘘引流,待感染控制后再行二期根治性手术。术后病理均提示高级别尿路上皮癌。结论临床医师应警惕以脓毒血症为首发症状的上尿路尿路上皮癌,加强全面检查,必要时行手术探查,并借助快速病理检查以尽早明确诊断。合理选择手术方式并优化术后治疗方案,对改善患者预后具有重要意义。Objective To investigate the clinical characteristics,treatment strategies and prognosis of ureteral carci-noma with sepsis as the first symptom.Methods The clinical data of three patients with upper urinary tract urothelial carcinoma with urinary sepsis as the first manifestation who were admitted to the First People's Hospital of Tianshui from August 2022 to October 2023 were retrospectively selected,including patient information and medical history,admission examination,imaging examination,postoperative treatment and follow-up.Results All the 3 patients were treated with low back pain and fever as the main symptoms.Among them,1 case was misdiagnosed as ureteral steno-sis in other hospitals,and radical surgery was performed after ureteral exploration.The other 2 patients underwent one-stage fistula drainage and underwent two-stage radical surgery after infection control.Postoperative pathology showed high-grade urothelial carcinoma.Conclusion Clinicians should be alert to upper urinary tract urothelial carci-noma with sepsis as the first symptom.Comprehensive examination should be strengthened,surgical exploration should be performed if necessary,and rapid pathological examination should be used to confirm the diagnosis as soon as possible.Reasonable selection of surgical methods and optimization of postoperative treatment are of great signifi-cance to improve the prognosis of patients.

关 键 词：脓毒血症 首发症状 上尿路尿路上皮癌 

分 类 号：R4[医药卫生—临床医学]