胃肠肿瘤致肾功能不全18例临床研究

【摘要】 目的  探讨胃肠肿瘤致肾功能不全的病因及防治措施。 方法  18例胃肠肿瘤致肾功能不全患者，观察其肾脏CT、病理、尿液分析、血电解质、肾功能、血尿酸、血红蛋白、总蛋白、癌胚抗原改变，并观察1年后肿瘤复发及远处转移情况，对照组选18例相同治疗条件下肾功能正常的胃肠肿瘤患者。 结果  18例患者肾脏CT示肿瘤浸润5例，肾盂积水5例，8例病检结果:弥漫性膜增生改变2例，尿酸肾病2例，小管间质损害4例，与对照组相比差异有显著性，血红蛋白、总蛋白、血钠较低（P<0.05）;而血UA、BUN、Cr水平增高（P<0.05）;血CEA与对照组比较差异无显著性（P>0.05）;18例患者肾功能不全完全治愈11例，好转7例，术后1年肿瘤复发远处转移有10例，死亡8例;对照组术后1年肿瘤复发远处转移有3例，死亡1例（P<0.05）。 结论  胃肠肿瘤致肾功能不全与肿瘤浸润;压迫致尿路梗阻;血电解质，代谢紊乱;免疫损害及营养状况有关。防治措施视病因而定，预后比对照组差。

    关键词  胃肠肿瘤 肾功能不全

    Clinical study of gastrointestinal tumors causing renal failure

       【Abstract】 Objective To study the mechanism and prevention method of gastrointestinal tumors causing renal failure.Methods 18patient diagnosed gastrointestinal tumors causing renal failure were detected their renal CT，serum UA，K，Na，Cl，Ca，Cr，CEA，TP，Hb，pathological type，tumor recovery and metastasis after1year.Gastrointesti-nal tumor patients with the nomal renal function were as the control.Results Renal CT showed tumor infiltration5cases，tumor compression caused hydronephrosis5cases，pathological result showed diffuse membrane proliferation2cases，UA nephrosis2cases，tubularinterstitial injury4cases，compared with the control，serum TP，Hb，Na was lower（P<0.05），while serum UA，BUN，Cr showed higher（P<0.05），CEA had no obvious difference（P>0.05）.Tu-mor recovery and metastasis after1year10cases，8cases died，while the control had3cases caused tumor recovery and metastasis after1year，died only1case（P<0.05）.Conclusion The mechanism of gastrointestinal tumors causing renal failure，tumor infiltration，tumor compression causing hydronephrosis，serum electrolyte and metabolism disorder，immune injury，nutritional status.Prevention and cur

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