膀胱全切术后不同尿流改道治疗肌层浸润性膀胱癌的研究  

The study of radical cystectomy for muscle invasive bladder cance with different urinary diversion

作　　者：吕志勇[1,2] 吴小候[1] 陈福宝[2] 李培军[2] 吴春华[2] 

机构地区：[1]重庆医科大学附属第一医院泌尿外科,400016 [2]宁夏医科大学附属医院泌尿外科,银川750004

出　　处：《重庆医学》2012年第2期140-141,共2页Chongqing medicine

摘　　要：目的探讨分析全膀胱切除术后4种尿流改道术式的临床效果。方法回顾性分析73例膀胱癌患者膀胱全切除后不同尿流改道术,其中输尿管皮肤造口术12例,回肠膀胱术(Bricker)41例,原位新膀胱术(Studer)11例,Sigma直肠膀胱术9例。对4组患者在出血量、手术时间、术后平均住院天数、术后并发症发生率等方面的情况进行统计学比较分析。结果回肠膀胱术组的手术时间、手术出血量比其它组多,输尿管皮肤造口术组的手术时间、术后平均住院天数少于其它组,差异有统计学意义(P<0.05)。原位新膀胱术组与Sigma直肠膀胱术组在手术时间、出血量、术后平均住院天数等方面比较差异无统计学意义(P>0.05)。结论膀胱全切术后4种尿流改道方式各有优、缺点,应根据患者的个体情况选择合适的手术方式。Objective To study the efficacy of radical cystectomy with four types of urinary diversion.Methods A total of 73 patients with urinary diversion after radical cystectomy,including 12 cases with ureterostomy,41 cases with Bricker operation,11 cases with orthotopic ileal neobladder,and 9 cases with sigma rectum pouch were analyzed retrospectively.Results There were significant differences in operation time and median blood loss between Bricker operation group and other groups（P0.05）.And there were significant difference in operation time and the median length of hospitalization between ureterostomy and other groups（P0.05）.There were no significant differences in operation time,median blood loss and the median length of hospitalization between Studer operation group and sigma rectum pouch groups（P0.05）.Conclusion Four types of urinary diversion have their own advantages,we should selecting the appropriate urinary diversion according to the individual condition of the patient.

关 键 词：膀胱肿瘤 膀胱切除术 尿流改道 

分 类 号：R737.14[医药卫生—肿瘤]