膀胱癌患者微创切除术后不同尿道改流方案的效果比较  

Effect of Urethral Reflow Plan after Minimally Invasive Surgery for Patients with Bladder Cancer

作　　者：王雪强 毕良宽[2] 曾显奎[1] 吴齐[1] 焦常宝 季金峰 WANG Xueqiang;BI Liangkuan;ZENG Xiankui(Chuzhou Clinical College of Anhui Medical University,Chuzhou,239000)

机构地区：[1]安徽医科大学滁州临床学院,239000 [2]安徽医科大学第二附属医院,230602

出　　处：《实用癌症杂志》2020年第3期438-440,444,共4页The Practical Journal of Cancer

摘　　要：目的探讨膀胱癌患者微创切除术后原位回肠膀胱术与输尿管皮肤造口术2种尿道改流方案的效果。方法回顾性选择51例肌层浸润型膀胱癌患者,根据根治性膀胱全切术后所用尿道改流术的不同分为2组,A组为原位回肠膀胱术组(26例),B组为输尿管皮肤造口术组(25例)。对比2组患者的围术期指标、近期并发症、远期并发症及术后9个月的生活质量评分。结果B组的手术时间、肠道功能恢复时间、术中出血量、术后住院时间明显少于A组(P<0.05)。A组的近期及远期并发症发生率高于B组,但组间对比无统计学意义(P>0.05)。2组患者的心理健康、生理功能、生理职能、情感职能、躯体疼痛、精力对比无统计学意义(P>0.05),但A组的社会功能、总体健康明显高于B组(P<0.05)。结论2种尿道改流方案各有优劣,对于膀胱癌行微创手术者,可根据患者具体情况选择合适的尿道改流方案。Objective To investigate the effect of 2 urethral diversion schemes in patients with bladder cancer after minimally invasive resection.Methods 51 cases of musculoinvasive bladder cancer were retrospectively selected,who were divided to 2 groups according to urethral revascularization after radical cystectomy.The group A was the Orthotopic ileo bladder surgery group(26 cases),and the group B was the ureterodermostomy group(25 cases).The perioperative indicators,recent complications,long-term complications and life quality scores 9 months after operation were compared in the 2 groups.Results The operative time,intestinal function recovery time,intraoperative blood loss and postoperative hospitalization time of the group B were significantly lower than that of the group A(P<0.05).The incidence of short-term and long-term complications was 23.1%in the group A and 8.0%in the group B,which in the group A was higher than that of the group B,while the comparison between the 2 groups had no statistically significant difference(P>0.05).There was no significant difference in mental health,physiological function,physiological function,emotional function,physical pain and energy between the 2 groups(P>0.05).The social function and overall health of the group A were significantly higher than that of the group B(P<0.05).Conclusion There are advantages and disadvantages of the 2 urethral reversal programs.For patients with minimally invasive surgery for bladder cancer,a suitable urethral reflow plan can be selected according to the specific conditions of the patient.

关 键 词：膀胱癌 原位回肠膀胱术 输尿管皮肤造口术 并发症 生活质量 

分 类 号：R737.14[医药卫生—肿瘤]