肠道准备在膀胱全切回肠输出道术中的意义探讨  

To explore the significance of bowel preparation(BP)for the patients who underwent radical cystectomy and ileal conduit surgery

作　　者：吴水清[1] 王自健[1] 何南[1] 钟朝晖[1] 赵晓昆[1] 张磊[1] 徐冉[1] 朱煊[1] 侯轶[1] 

机构地区：[1]中南大学湘雅二医院泌尿外科,长沙410011

出　　处：《现代泌尿生殖肿瘤杂志》2015年第5期275-277,共3页Journal of Contemporary Urologic and Reproductive Oncology

摘　　要：目的探讨肠道准备对根治性膀胱全切回肠输出道术患者的意义。方法 2006年3月至2014年12月间,将中南大学湘雅二医院106例准备施行根治性膀胱全切回肠输出道术的患者,随机分为术前肠道准备组(A组)及术前无肠道准备组(B组),观察比较两组的手术时间、患者恢复情况和手术并发症。结果共106例患者,其中A组57例,B组49例。所有手术均成功并使用了回肠。A、B组发生术后并发症的例数分别为11、10例。其中,A组1例吻合口漏,导致多器官功能障碍和败血症,患者最终死亡,3例肠梗阻,7例伤口感染。而B组4例伤口感染,4例肠梗阻,1例吻合口瘘发展,导致再次手术,1例因肺动脉栓塞死亡。两组所观察到的并发症例数及患者恢复情况差异无统计学意义。结论术前的肠道准备对根治性膀胱全切回肠输出道术患者没有优势。Objective To explore the significance of bowel preparation （BP）for the patients who underwent radical cystectomy and ileal conduit surgery. Methods Between Match 2006 and December 2014,106 patients scheduled for radical cystectomy and ileal conduit were randomized to preoperative BP （group A）or surgery without BP （group B）.Outcomes studied included operative time,recovery of patient and surgical complications. Results One hundred and two patients were included in the study,57 in group A and 49 in group B.All surgeries were performed successfully u-sing ileum.Postoperative complications were documented in 1 1 and 10 patients in groups A and B, respectively.Anastomotic leak occurred in 1 patient in group A,leading to multiple organ dysfunc-tion and sepsis,with a fatal outcome.3 cases of ileus and 7 wound infections were also seen in group A.In group B,4 wound infections and 4 ileus,anastomotic leak developed in 1 patient resulting to reoperation and 1 patient died from pulmonary embolism.No statistical difference in the frequency of complications and recovery of patient was observed between the 2 groups. Conclusions Our results suggest that no advantage is gained by preoperative BP in radical cystectomy and ileal conduit.

关 键 词：肠道准备 根治性膀胱全切 回肠输出道 术后并发症 

分 类 号：R737.14[医药卫生—肿瘤]