可控性“Y”型乙直肠膀胱术  

A SURGICAL PROCEDURE OF CONTROLLED Y-TYPE URINAPY BLADDER RECONSTRUCTION WITH SIGMOIDORECTOSTOMY

作　　者：韩启光[1] 张成友[1] 潘辅全[1] 党鸿毅[1] 

机构地区：[1]海南医学院附属新华医院泌尿外科,海口570311

出　　处：《海南医学院学报》1999年第4期156-158,共3页Journal of Hainan Medical University

摘　　要：目的：在动物实验基础上，创建一种膀胱癌根治后，新的“Ｙ”型乙直肠膀胱术。方法：在建立肠道连续通道时，将乙状结肠与直肠作套叠式端侧吻合，在作输尿管移植时作抗逆流整形，同时于乙直肠交界缩窄制成漏斗形活瓣。结果：１４ 例术后Ⅰ期愈合，随访１８～６０ 个月，患者排尿控制自如，每次尿量２００～４００ ｍ ｌ，经直肠测压，静止压平均１．７８ ｋＰａ，排尿平均压４．８５ ｋＰａ，近似膀胱压力曲线，无尿路逆流现象，无１ 例发生高氯血症和肾盂肾炎。结论：“Ｙ”型乙直肠膀胱具有良好的温度感和容量感，且手术简便易行，是一种尿流改道的有效方法。Objective: To study the superiority of the surgical procedure of controlled Y type bladder with sigmoidorectostomy on the basis of animal experiments Method: The junction of the proctosigmoid was cut at about 8 to 10 cmto superimpose the sigmoid with the anterorectum by way of a annular valve in the shape of a funnel Then the anti reflux transplantation of the ureter was performed on to the sigmoid Results: phase I recovery from surgery was achieved in 14 cases In the period of 18 to 60 months of follow ups, the patients could control their urination freely A static pressure of 1 78 kPa and a urinary pressure of 4 85 kPa in the rectum were noticed which are similar to the normal bladder pressure None of the patients operated on suffered from regurgitation of urine, hyperchloremia and/or pyelonephritis Conclusion: The procedure can serve as an effective approach in the transformation of the urinary tract as it is easy to perform and has considerable sensitivity to both temperature and volume

关 键 词：膀胱癌 膀胱切除术 尿路分流术 可控性Y型乙直肠膀胱术 

分 类 号：R737.14[医药卫生—肿瘤] R730.56[医药卫生—临床医学]