W型原位回肠代膀胱术后尿控功能变化的临床研究  

Clinical study on changes of continence function after W-shape orthotopic ileal neobladder

作　　者：王声兴[1] 梁培育[1] 欧善际[1] 韩一南[1] 

机构地区：[1]海南医学院第一附属医院泌尿外科,海口570102

出　　处：《山西医科大学学报》2016年第10期938-940,共3页Journal of Shanxi Medical University

摘　　要：目的探讨W型原位回肠代膀胱术后患者的尿控功能变化情况。方法取50例行原位回肠代膀胱术后患者作为实验组,50例因上尿路疾病需要手术治疗但下尿路功能正常的患者作为对照组。对两组压力流率检测以及膀胱镜检结果进行分析比较。结果实验组患者逼尿肌收缩力较对照组减弱(P<0.000 1)。实验组患者最大尿流率较对照组降低[(9±4.3)ml/s vs(19±3.6)ml/s,P<0.05];实验组容量为(593±126)ml,对照组为(460±80)ml,两组比较差异有统计学意义(P<0.05);实验组残余尿量为(225±136)ml,对照组为(10±7)ml(P<0.05);实验组顺应性为(18±5.2)ml/cm H2O,对照组为(32±9.3)ml/cm H2O(P<0.05);实验组排尿期最大压为(50±18)cm H2O,对照组为(70±19)cm H2O,两组比较差异有统计学意义(P<0.05)。实验组膀胱镜检5例为代膀胱出口梗阻,对照组膀胱镜检均未见异常,两组比较差异有统计学意义(P=0.022)。结论原位回肠代膀胱较正常膀胱有较好的储尿功能,但排尿功能差。Objective To investigate the continence function after W-shape orthotopic ileal neobladder. Methods Fifty patients with W-shape orthotopic ileal neobladder（ experimental group） and 50 patients with upper urinary tract diseases but with normal function of lower urinary tract（ control group） were included in this study. The pressure flow rate and cystoscopy examination were compared between the two groups. Results Intensity of detrusor contraction in experimental group was lower than in control group（ P〈0. 000 1）.The maximum urinary flow rate[（ 9 ± 4. 3） ml / s vs（ 19 ± 3. 6） ml / s,P〈0. 05 ],capacity [（ 593 ± 126） ml vs（ 460 ± 80） ml,P〈0. 05],residual urine volume [（ 225 ± 136） ml vs（ 10 ± 7） ml,P〈0. 05 ],compliance [（ 18 ± 5. 2） ml / cm H2 O vs（ 32 ± 9. 3） ml /cm H2 O,P〈0. 05]and maximum micturition pressure[（ 50 ± 18） cm H2 O vs（ 70 ± 19） cm H2 O,P〈0. 05] in experimental group were significantly different from those in control group. Five patients showed the obstruction of neobladder outlet tested by cystoscopy in experimental group,while no abnormality was found in control group（ P = 0. 022）. Conclusion Orthotopic ileal neobladder has a better storage function than that of normal bladder,but it has poor function of micturition.

关 键 词：W型原位回肠代膀胱 尿控 膀胱镜 

分 类 号：R694[医药卫生—泌尿科学]