水囊新法打输尿管隧道在宫颈癌根治术中的应用分析(1)
[摘要] 目的 探討水囊新法打输尿管隧道在宫颈癌根治术中的应用价值。 方法 回顾分析2018年 6 ～12月在我院确诊的宫颈癌患者临床资料，其中用水囊新法处理输尿管16例(A组)、输尿管导管处理输尿管21例(B组)。比较两组患者手术时间、术中出血量、术后尿管拔除时间、尿潴留发生率、输尿管损伤率、术后发热率、尿路感染发生率等。 结果 A组手术时间明显短于B组，但差异无统计学意义(P>0.05);两组患者术中出血量、术后住院时间、术后尿管拔除时间、术后尿潴留发生率比较差异无统计学意义(P>0.05)。A组术后抗生素使用时间明显短于B组，术后发热、尿路感染、术后血尿发生率明显低于B组，差异均有统计学意义(P均<0.05)。两组患者术中、术后均未发生输尿管损伤。术后 3 个月随访过程中，B组患者中4例出现尿路感染，1例出现肾积水，A组患者无尿路感染或泌尿系统损伤的发生。 结论 在行广泛子宫切除手术时，为避免术中输尿管损伤，术中水囊新法打输尿管隧道是可行的，可有效避免术中输尿管的损伤，不增加患者经济负担，且不增加术后并发症的发生，具有临床推广价值。
[关键词] 双腔水囊管;输尿管导管;输尿管隧道;宫颈癌
[中图分类号] R713.4 [文献标识码] B [文章编号] 1673-9701(2019)29-0079-04
Application analysis on new method of water bag hitting transurethral tunnel in radical resection of cervical cancer
SHU Li CHEN Qiong DAI Mimi QIAN Yiyu GENG Xiaohong
Department of Gynecology， the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University， Wenzhou 325000， China
[Abstract] Objective To investigate the application value of new method of water bag hitting transurethral tunnel in the radical resection of cervical cancer. Methods The clinical data of patients with cervical cancer who were diagnosed in our hospital from June to December 2018 were retrospectively analyzed. Among them， 16 cases of ureter (group A) were treated with the new method of water bag， 21 cases of ureter (group B) were treated with ureteral catheter. The operation time， intraoperative blood loss， postoperative urinary catheter removal time， urinary retention rate， ureteral injury rate， postoperative fever rate， and incidence of urinary tract infection were compared between the two groups. Results The operation time in group A was significantly shorter than that in group B， but the difference was not statistically significant (P>0.05); there was no statistically significant difference in the amount of intraoperative blood loss， postoperative length of hospital stay， postoperative urinary catheter removal time， and incidence rate of postoperative urinary retention between the two groups (P>0.05). The antibiotic use time in group A was significantly shorter than that in group B. The incidence rate of postoperative fever， urinary tract infection and postoperative hematuria was significantly lower than that in group B， and the difference was statistically significant (P<0.05 for both). No ureteral injury was seen in both groups during and after surgery. During the 3-month follow-up period， four patients in group B developed urinary tract infection and one patient developed hydronephrosis. Patients in group A had no urinary tract infection or urinary system damage. Conclusion In the course of extensive hysterectomy， in order to avoid intraoperative ureteral injury， it is feasible to use the new method of water bag hitting transurethral tunnel in the operation. It can effectively avoid the injury of the ureter during operation， does not increase the economic burden of the patient， and does not increase the incidence of postoperative complications， which has a clinical promotion value., 百拇医药(舒莉 陈琼 戴蜜蜜 钱益宇 耿筱虹)
[关键词] 双腔水囊管;输尿管导管;输尿管隧道;宫颈癌
[中图分类号] R713.4 [文献标识码] B [文章编号] 1673-9701(2019)29-0079-04
Application analysis on new method of water bag hitting transurethral tunnel in radical resection of cervical cancer
SHU Li CHEN Qiong DAI Mimi QIAN Yiyu GENG Xiaohong
Department of Gynecology， the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University， Wenzhou 325000， China
[Abstract] Objective To investigate the application value of new method of water bag hitting transurethral tunnel in the radical resection of cervical cancer. Methods The clinical data of patients with cervical cancer who were diagnosed in our hospital from June to December 2018 were retrospectively analyzed. Among them， 16 cases of ureter (group A) were treated with the new method of water bag， 21 cases of ureter (group B) were treated with ureteral catheter. The operation time， intraoperative blood loss， postoperative urinary catheter removal time， urinary retention rate， ureteral injury rate， postoperative fever rate， and incidence of urinary tract infection were compared between the two groups. Results The operation time in group A was significantly shorter than that in group B， but the difference was not statistically significant (P>0.05); there was no statistically significant difference in the amount of intraoperative blood loss， postoperative length of hospital stay， postoperative urinary catheter removal time， and incidence rate of postoperative urinary retention between the two groups (P>0.05). The antibiotic use time in group A was significantly shorter than that in group B. The incidence rate of postoperative fever， urinary tract infection and postoperative hematuria was significantly lower than that in group B， and the difference was statistically significant (P<0.05 for both). No ureteral injury was seen in both groups during and after surgery. During the 3-month follow-up period， four patients in group B developed urinary tract infection and one patient developed hydronephrosis. Patients in group A had no urinary tract infection or urinary system damage. Conclusion In the course of extensive hysterectomy， in order to avoid intraoperative ureteral injury， it is feasible to use the new method of water bag hitting transurethral tunnel in the operation. It can effectively avoid the injury of the ureter during operation， does not increase the economic burden of the patient， and does not increase the incidence of postoperative complications， which has a clinical promotion value., 百拇医药(舒莉 陈琼 戴蜜蜜 钱益宇 耿筱虹)