回肠膀胱扩大术在中晚期肾结核中的应用  

Ileocystoplasty used in the treatment of advanced renal tuberculosis

作　　者：李蒙[1] 魏金星[1] 张雪培[1] 王智勇[1] 李军[1] 冯德胜[1] 

机构地区：[1]郑州大学第一附属医院泌尿外科,450052

出　　处：《中国实用医刊》2013年第12期26-27,共2页Chinese Journal of Practical Medicine

摘　　要：目的研究回肠膀胱扩大术在中晚期肾结核治疗中的临床效果。方法回顾性分析郑州大学第一附属医院2011年7月至2012年7月诊治的47例中晚期肾结核患者的临床资料，患者均行肾切除术（肾脏＋输尿管＋部分膀胱），其中12例患者术后因尿频症状改善不明显行回肠膀胱扩大术。比较35例单纯行肾切除组与12例回肠膀胱扩大术组患者术后对侧肾积水的变化情况。结果术后1个月复查彩超，单纯行肾切除组患者对侧肾脏肾积水（集合系统分离大小）较术前减轻2～8mm，平均5mm；回肠膀胱扩大术组患者对侧肾脏肾积水（集合系统分离大小）较术前减轻14～25mm，平均20mm。行回肠膀胱扩大术组患者较单纯行肾切除组患者术后对侧肾积水情况有明显改善[（19．67±2．06）mmvs（5．06±1．49）mm]，差异有统计学意义（P〈0．05）。结论回肠膀胱扩大术作为治疗膀胱挛缩的主要方法之一，可使中晚期肾结核患者对侧肾脏积水情况得到有效改善，并且能够在一定程度提高患者的生活质量，因此，回肠膀胱扩大术是治疗中晚期肾结核的一种安全有效的手术方式。Objective To study the preliminary clinical results of the ileocystoplasty for the treatment of renal tuberculosis. Methods Retrospectivly analyse the diagnosis and treatment of the clinical data of 47 patients with advanced renal tuberculosis from July 2011 to July 2012, the patients underwent nephrectomy （ kidney ± ureter ± partial bladder） ; of which 12 patients were no obvious improvement in the symptoms of frequent urination, accept the ileocystoplasty. Compared 35 cases of simple nephrectomy group and 12 cases of ileocystoplasty group with contralateral hydronephrosis changes. Results Postoperative of one month review of ultrasound, among the patients with simple nephrectomy, the contralateral kidney hydronephrosis （collection system separation size） compared with the preoperative reduce 2 -8 mm, average 5 mm; among the patients with ileocystoplasty, the contralateral kidney hydronephrosis （eollectionsystem separation size ） compared with the preoperative to reduce 14 -25 mm, average 20 mm. Compared the patients with ileocystoplasty and the patients with simple nephrectomy with contralateral hydronephrosis situation significantly improved [ （ 19.67 ± 2.06 ） mm vs. （ 5.06 ± 1.49 ） ram, P 〈 0. 05 ） ]. Conclusions Ileocystoplasty as one of the main methods for the treatment of bladder contracture in patients with advanced renal tuberculosis, the contralateral kidney hydronephrosis can be effectively improved, and can improve patients＇ quality of life to a certain extent, therefore, ileocystoplasty is a safe and effective surgical approach for advanced renal tuberculosis.

关 键 词：肾结核 肾切除 回肠膀胱扩大术 

分 类 号：R527.1[医药卫生—内科学]