早期应用一件式造口袋处理根治性膀胱全切患者术后尿外渗  

Ostomy bags in management of perioperative urine leakage in bladder cancer patients after radical cystectomy:a report of 97 cases

作　　者：李雪梅[1] 季惠翔[1] 李珍燕[1] 张静[1] 陈志文[1] 方强[1] 

机构地区：[1]第三军医大学西南医院全军泌尿外科研究所,重庆400038

出　　处：《第三军医大学学报》2012年第18期1870-1872,共3页Journal of Third Military Medical University

基　　金：第三军医大学临床创新基金(2010XLC02)~~

摘　　要：目的评估早期应用一件式造口袋处理根治性膀胱全切患者术后尿外渗的相关费用及对患者围手术期生活质量的影响。方法 2003年1月至2010年12月本所收治根治性膀胱全切术尿流改道和重建患者483例,其中术后发生尿外渗者97例。根据尿外渗的不同处置方法分为A组:常规更换敷料处置(53例),B组:早期应用一件式造口袋处置(44例),统计2组患者尿外渗处理相关费用并采用欧洲生活质量量表(EuroQol)评估患者术后生活质量。结果 B组患者尿外渗处置平均费用显著低于A组,且B组的总体生活质量评分显著高于A组,尤其是在疼痛/不适的描述参数存在显著差异。结论在保持引流管通畅情况下,早期应用一件式造口袋处理根治性膀胱全切术后尿外渗,能够显著改善患者围手术期生活质量,降低相关医疗费用和医护资源,具有一定的推广应用价值。Objective To evaluate the clinical efficiency of ostomy bag in the management of urine leakage in patients with bladder cancer after radical cysteetomy. Methods From January 2003 to December 2010, 483 patients with bladder cancer received radical cystectomy and then urinary diersion and reconstruc- tion, and 97 from them were found with urinary extravasation. These patients were then randomly divided into group A （53 cases） and group B （44 cases） respectively. All patients of group A were treated by routine dress- ing changes. The leakages of group B were managed with ostomy bags. Perioperative quality of life was evalua- ted with EuroQoL Quality of Life Scale （EuroQol）. The results and cost for urine leakage for both groups were compared. Results The average cost in management of perioperative urine leakage was significantly lower in group B than in group A. Patients in group B had an overall better perioperative life quality compared to group A. In particular, the score for pain/discomfort was significantly higher in group B than in group A. Conclusion The management of perioperative urine leakage with ostomy bags avoids constantly body wet, significantly in- creases the quality of life, and reduces the special costs of urine leakage in patients with bladder cancer after radical cystectomy.

关 键 词：尿流改道 膀胱癌 尿外渗 生活质量 

分 类 号：R472.92[医药卫生—护理学] R619[医药卫生—临床医学]