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血尿是放疗和(或)环磷酰胺化疗后的常见并发症。许多病人应用盆腔放疗或化疗(如妇科恶性肿瘤应用的环磷酰胺)后常出现严重血尿。此并发症在放疗或化疗结束后可持续许多年,而与有无残留病变无关。本文报道的一种简易连续膀胱冲洗法可治疗这种并发症。方法先行膀胱镜检,清除膀胱内血块,然后安置连续冲洗系统。首先将8号饲管插入膀胱,再插入F18-22Foley导管。用5ml水充盈导管气囊,饲管尖端置入膀胱深部,导管尖端则位于膀胱颈部。从饲管连续灌注生理盐水,再经导管流出。冲洗速度按出血速度调节,即按流出液体的颜色决定。流出液体转清时,即停止冲洗,导管于第二天拔出。讨论对于既往有放疗和(或)环磷酰胺化疗病史的血尿病人,应作全面分析。包括全血细胞计数,凝血酶原时
Hematuria is a common complication after radiotherapy and/or cyclophosphamide chemotherapy. Many patients often experience severe hematuria after pelvic radiotherapy or chemotherapy (such as cyclophosphamide for gynecologic malignancy). This complication can persist for many years after the end of radiotherapy or chemotherapy, regardless of whether there is residual disease. A simple continuous bladder irrigation method reported here can treat this complication. Methods Cystoscopy was first performed to remove blood clots from the bladder and then a continuous flushing system was placed. First, the 8th feeding tube was inserted into the bladder and the F18-22 Foley catheter was inserted. The catheter balloon was filled with 5 ml of water. The tip of the feeding tube was placed deep into the bladder and the catheter tip was located in the bladder neck. The physiological saline was continuously infused from the feeding tube and then discharged through the catheter. The flushing speed is adjusted according to the bleeding speed, which is determined by the color of the outflowing liquid. When the effluent liquid turns clear, the flushing is stopped and the catheter is withdrawn on the next day. DISCUSSION Comprehensive analysis should be performed on patients with hematuria who have previous history of radiotherapy and/or cyclophosphamide chemotherapy. Including full blood cell count, prothrombin time