直肠癌根治术后膀胱排空障碍原因及处理  

Bladder dysfunction after rectal cancer surgery: Causes and treatments

作　　者：李乐平[1] 刘兆瑞[1] 陈悦之[1] 靖昌庆[1] 

机构地区：[1]山东大学附属省立医院胃肠外科,济南250021

出　　处：《中华普外科手术学杂志（电子版）》2014年第2期30-32,共3页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：山东省卫生厅(2007QZ015);山东省科技攻关课题(2011GGB14158);山东省自然基金(ZR2011HM041)

摘　　要：在直肠全系膜切除术提出前，直肠癌术后膀胱排空障碍的发生率高达40．0％～60．0％，目前该并发症的发生率现已降至不足5．0％。外科手术是直肠癌术后膀胱排空障碍的主因：盆腔神经损伤、经腹会阴联合手术均会影响排尿功能，而术前排尿功能障碍等因素亦是引起该并发症的原因。对于该并发症的处理主要应注意术中仔细操作，人工神经管再造及骶神经电刺激亦为治疗直肠癌术后膀胱排空障碍提供了新的思路。Before the introduction of principles of total mesorectal excision （TME）, the reported incidence of bladder dysfunction after rectal cancer surgery ranged from 40.0% to 60.0%.The current incidence of post-operative bladder dysfunction has been decreased to below 5.0%.Bladder dysfunction after rectal cancer treatment is mainly caused by surgical factors , including injury of pelvic autonomic plexus , abdominoperineal resection, preoperative voiding dysfunctions and so on .Special attention to the pelvic autonomic nerves and careful surgical approach are required .Artificial nerve conduit and sacral nerve stimulation would provide a new idea for the management of post-operative bladder dysfunction .

关 键 词：直肠肿瘤 结直肠外科手术 手术后并发症 排尿障碍 

分 类 号：R735.37[医药卫生—肿瘤]