膀胱全切除肠代膀胱术对膀胱癌患者肠道功能的影响  

Effects of total cystectomy intestinocystoplasty on intestinal function of patients with bladder cancer

作　　者：游加芹 游春艳 耿杰[1] 

机构地区：[1]湖北医药学院附属随州医院泌尿外科,湖北随州441300 [2]随州洪山医院,湖北随州441318

出　　处：《结直肠肛门外科》2016年第1期62-65,共4页Journal of Colorectal & Anal Surgery

摘　　要：目的探讨膀胱全切除肠代膀胱术对膀胱癌患者肠道功能的影响。方法回顾性分析2011年4月至2013年12月于我院行膀胱全切除肠代膀胱术的42例膀胱癌患者临床资料,根据其术式分成腹腔镜组(24例)和开放组(18例)。对比两组受试者围术期指标(平均手术时间、术中出血量、总住院时间等)及肠道功能指标(肠鸣音出现时间、肠道恢复通气时间、术后首次排便时间等)差异;行术后24个月随访,分析其手术前后尿动力学指标(最大尿流率、膀胱容量、残余尿量、日间控尿率、夜间控尿率等)变化情况。结果 1两组受试者平均手术时间对比无统计学意义(P>0.05);腹腔镜组术中出血量[(234.5±52.6)ml]、总住院时间(5.5±1.3)d、术后肠鸣音出现时间(39.5±10.5)h、肠道恢复通气时间(59.9±12.5)h和首次排便时间(72.5±15.2)h均显著低于开放组(P<0.05);2术后12个月和24个月时,两组受试者最大尿流率、膀胱容量均较术前显著提升,残余尿量则较术前显著降低(P<0.05),但组间对比无统计学意义(P>0.05);手术前后,两组受试者日、夜间控尿率对比均无统计学意义(P>0.05)。结论膀胱全切除肠代膀胱术不仅可有效改善膀胱癌患者排尿功能,还对其肠道功能的不良影响轻微,于患者预后恢复有利。Objective To explore effects of total cystectomy intestinocystoplasty on intestinal function of patients with bladder cancer. Methods A restrospective analysis of clinical data was carried out among 42 patients with bladder cancer treated with total cystectomy intestinocystoplasty in our hospital from April 2011 to December2013, according to operation types, they were divided into the laparoscopy group（n=24） and the open group（n=18）. Differences of perioperative indexes [mean operation time, intraoperative blood loss, total hospitalization time, etc.] and intestinal function indexes [appearance time of intestinal sound, intestinal recovery ventilation time, the first defecation time, etc.] were compared; changes of urodynamics indexes [maximum flow rate, bladder volume, residual urine volume, continence rate during the day, continence rate at night, etc.] before and after the operation were analyzed following up to 24 months Results 1 There was no significant difference in the mean operation time between the two groups（P〈0.05）; intraoperative blood loss [（234.5±52.6） ml], total hospitalization time [（5.5±1.3） d], postoperative appearance time of intestinal sound [（39.5±10.5） h], Intestinal recovery ventilation time [（59.9±12.5） h] and the first defecation time [（72.5±15.2） h] in the laparoscopy group were significantly lower than that in the open group（P〈0.05）. 2 12 months and 24 months after operation, maximum flow rate and bladder volume in the two groups were significantly higher than that before the operation, and residual urine volume was significantly lower than that before the operation（P〈0.05）, but there was no significant difference between the groups（P〉0.05）; there was no significant difference in continence rate during the day and at night before and after the operation between the two groups（P〉0.05）. Conclusion Total cystectomy intestinocystoplasty not only can improve the urinary function of bladder cancer patients effectively, but also h

关 键 词：膀胱全切除术 肠代膀胱术 膀胱癌 肠道功能 

分 类 号：R737.14[医药卫生—肿瘤]