改良低压回肠代膀胱术的疗效评价  

Evaluation of postoperative modified low-pressure orthotopic ileal neobladder

作　　者：吴志强 林春瑞 尹建福 张遵俊 

机构地区：[1]福建省邵武市立医院泌尿科外科,福建邵武354000

出　　处：《现代泌尿外科杂志》2007年第6期363-365,共3页Journal of Modern Urology

摘　　要：目的总结改良原位低压回肠代膀胱术的疗效及患者生活质量。方法膀胱癌患者53例,平均年龄61岁,均施行根治性膀胱全切术。截取末端35-45 cm回肠,"U"形缝合形成代"膀胱",并与输尿管形成抗返流的"乳头"缝合。结果术后所有患者血生化及电解质均正常,随访3-6个月,51例患者白天完全可控排尿,完全夜间可控制排尿25例。47例无残余尿,5例有残余尿20-35 mL。结论改良低压回肠代膀胱术,膀胱容量大、压力低、无返流、效果好、无吸收性酸中毒,患者白天均能够控制尿液,夜间需定时排尿,生活质量高,多数患者满意。Objective To discuss the efficacy of modified low-pressure orthotopic ileal neobladder and the patients＇ qualify of life. Methods Radical cystectomy and ileal neobladder was performed in 53 cases with bladder carcinoma. To construct the reservoir, a 35- 45 cm ileal segnent was isolated along its antimesenteric border and then arranged into a U-shape. The incised ileum was sutured blanketly to create a urine bag. The urters were replanted at the two comers of the U-shape by creating a ＂nipple＂. Results All patient＇s blood biochemical analysis and electrolyte were normal without hyper chloraemia after operation. All patients had been followed up for 3-- 6 months. 51 of the 53 cases had achieved excellent daytime continence, whereas 25 cases had nightime continence. 47 cases had no postvoid residual urine, and only 5 cases had 20--35 mL postvoid residual urine. Conclusion The modified low-pressure orthotopic ileal neobladder is effective and reiable in treating patients with bladder carcinoma.

关 键 词：膀胱肿瘤 膀胱切除术 回肠膀胱 生活质量 

分 类 号：R694[医药卫生—泌尿科学]