宫颈癌根治术后反射性尿闭1例报告并文献复习

doi:10.13481/j.1671-587x.20150436

吉林大学学报(医学版) ›› 2015, Vol. 41 ›› Issue (04): 854-857.doi: 10.13481/j.1671-587x.20150436

宫颈癌根治术后反射性尿闭1例报告并文献复习

张静文, 郑连文, 常笑语, 刘永正, 高利伟, 付璐璐, 徐影

吉林大学第二医院妇产科, 吉林长春 130041

收稿日期:2015-02-27 发布日期:2015-08-01
通讯作者: 徐影,主治医师(Tel:0431-88796331,E-mail:xiaoai5777@163.com) E-mail:xiaoai5777@163.com
作者简介:张静文(1991-),女,山东省聊城市人,在读医学硕士,主要从事妇科肿瘤方面的研究。
基金资助:
吉林省科技厅重点项目资助课题(20120449)

Reflex anuria after radical hysterectomy:A case report and literature review

ZHANG Jingwen, ZHENG Lianwen, CHANG Xiaoyu, LIU Yongzheng, GAO Liwei, FU Lulu, XU Ying

Department of Obstetrics and Gynecology, Second Hospital, Jilin University, Changchun 130041, China

Received:2015-02-27 Published:2015-08-01

摘要/Abstract

摘要：

目的: 探讨宫颈癌术后反射性尿闭的临床特点,并分析其诊断及治疗方法。方法: 结合文献复习,回顾性分析本院收治的1例宫颈癌根治术后反射性尿闭患者的临床资料。该患者行宫颈癌根治术后69 h无尿,血肌酐渐进性升高至620.7 μmol·L^-1。病程中对该患者进行补液、纠正水和电解质紊乱、利尿、解痉治疗,同时行输尿管支架植入术,并给予药物降压等积极治疗。结果: 患者于宫颈癌根治术后第69小时开始有尿液排出,肾功能逐渐恢复正常。治疗后随访4个月,患者排尿正常,肾功能亦完全正常。结论: 反射性尿闭在临床上罕见,但易致急性肾损伤,且容易误诊。早期诊断通常可使反射性尿闭患者在经药物或手术治疗后顺利得以救治。

关键词: 宫颈肿瘤/诊断, 宫颈肿瘤/外科学, 子宫切除术, 反射性尿闭

Abstract:

Objective To investigate the clinical features of reflex anuria after radical hysterectomy,and to analyze its diagnosis and treatment methods. Methods Combined with reviewing the relevant literature,the clinical data of a case of reflex anuria after radical hysterectomy in our hospital was retrospectively analyzed.This patient developed anuria of 69 h duration after radical hysterectomy in our hospital,and the serum creatinine level gradlually increased to 620.7 μmol·L^-1.The patient was managed with correction of fluid and electrolyte imbalances,diuretics,and relieving the intrarenal arteriolar spasm and ureteral spasm.At the same time,the patient underwent ureteral catheterization and control of hypertension. Results By the 69th hour after undergoing radical hysterectomy in the patient,diuresis was established.The kidney function continued to improve for the remaining course of the hospitalization.The micturition and the kidney function of the patients were normal during the 4 months following-up. Conclusion Reflex anuria which is proved to cause acute kidney injury is rare in clinic,and it is easily misdiagnosed.The patients with reflex anuria can be successfully managed with medical or surgical interventions if this disease can be early diagnosis.

Key words: cervix neoplasms/diagnosis, cervix neoplasms/surgery, hysterectomy, reflex anuria

中图分类号:

R737.33

张静文, 郑连文, 常笑语, 刘永正, 高利伟, 付璐璐, 徐影. 宫颈癌根治术后反射性尿闭1例报告并文献复习[J]. 吉林大学学报(医学版), 2015, 41(04): 854-857.

ZHANG Jingwen, ZHENG Lianwen, CHANG Xiaoyu, LIU Yongzheng, GAO Liwei, FU Lulu, XU Ying. Reflex anuria after radical hysterectomy:A case report and literature review[J]. Journal of Jilin University Medicine Edition, 2015, 41(04): 854-857.

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宫颈癌根治术后反射性尿闭1例报告并文献复习

Reflex anuria after radical hysterectomy:A case report and literature review

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