三种正位新膀胱术后膀胱功能的临床观察  

Clinical comparison of bladder function after three types of orthotopic continent neobladder

作　　者：刘朝东[1] 胡钢[1] 陈在贤[1] 吴小候[1] 苟欣[1] 马笑光[1] 

机构地区：[1]重庆医科大学附属第一医院泌尿外科,400016

出　　处：《中华泌尿外科杂志》2007年第8期541-543,共3页Chinese Journal of Urology

摘　　要：目的评价3种正位新膀胱术式患者术后膀胱功能。方法胃代膀胱术后患者38例、回肠代膀胱术后31例、乙状结肠代膀胱术后33例,术后1～3个月随访患者排尿状况、上尿路B超、肾图或IVU检查、尿动力学检查,统计学分析比较各组疗效。结果胃代膀胱术后排尿通畅性较好,最大尿流率（17．2±6．2）ml/s,尿路感染发生率5％,膀胱容量（230±56）ml、尿失禁26％、遗尿21％；回肠代膀胱术和乙状结肠代膀胱术后膀胱容量分别为（320±70）ml、（300±60）ml,尿失禁分别为6％、9％,遗尿分别为6％、9％；上尿路梗阻和返流发生率均较低,与胃代膀胱术比较差异有统计学意义（P＜0．05）。结论3种代膀胱术术后膀胱贮尿功能良好,以回肠代膀胱术和乙状结肠代膀胱术后功能更好,胃代膀胱术由于其胃壁的生理特点在新膀胱抗感染和排尿功能方面满意。To compare the clinical effects of three different types of orthotopic continent neobladder. Methods From 1996 to 2005, 38 cases of orthotopic gastric neobladder, 31 cases of orthotopic ileac neobladder, 33 cases of orthotopic sigmoid-colonic neobladder were followed up and reviewed. The follow up examination included urination, ultrasonography in upper urinary tract, nephrogram,intravenous urography and urodynamics. Results were statistically analyzed and compared. Results For orthotopic gastric neobladder, urination was unobstructed, and the maximum urine flow rate was （17.2±6.2）ml/s and the incidence of urinary tract infection was 5 %, while bladder volume was （230±56）ml, incidence of incontinent was 26% and enuresis was 21%. For orthotopic ileac neobladder and orthotopic sigmoid-colonic neobladder , bladder volume was （320 ± 70）ml and （300 ± 60） ml, respectively, incidence of incontinent was 6% and 9%, enuresis was 6% and 9% respectively. The upper urinary tract obstruction and reflux of ileac neobladder and sigmoid-colonic neobladder were rarer compared with gastric neobladder（P〈0.05）. Conclusions The bladder storing function is fine for all three types of neobladder, especially in orthotopic ileac neobladder or orthotopic sigmoid-colonic neobladder. The orthotopic gastric neobladder is better in anti infection and urinating

关 键 词：膀胱 癌 结核 尿流改道 

分 类 号：R686[医药卫生—骨科学]