腹腔镜膀胱全切术后回肠通道术、输尿管皮肤造口术在膀胱癌患者中的应用效果  

Application effect of ileal conduit and ureterocutaneostomy after laparoscopic total cystotomy in patients with bladder cancer

作　　者：邵长帅 任小强[1] 王鸿渊 SHAO Changshuai;REN Xiaoqiang;WANG Hongyuan(Department of Urology,College of Clinical Medicine of He’nan University of Science and Technology/the First Affiliated Hospital of He’nan University of Science and Technology,Luoyang 471003,He’nan,China)

机构地区：[1]河南科技大学临床医学院/河南科技大学第一附属医院泌尿外科,河南洛阳471003

出　　处：《癌症进展》2025年第1期40-42,94,共4页Oncology Progress

摘　　要：目的探讨腹腔镜膀胱全切术后回肠通道术、输尿管皮肤造口术在膀胱癌患者中的应用效果。方法根据腹腔镜膀胱全切术后尿流改道方式的不同将80例膀胱癌患者分为A组(n=39,回肠通道术)和B组(n=41,输尿管皮肤造口术)。比较两组患者的手术相关指标、应激反应指标[皮质醇(Cor)、肾上腺素(E)及去甲肾上腺素(NE)]及并发症发生情况。结果B组患者术中出血量明显少于A组,手术时间、肠道功能恢复时间及住院时间均明显短于A组,差异均有统计学意义(P﹤0.01)。术后,两组患者NE、E、Cor水平均低于本组术前,B组患者NE、E、Cor水平均低于A组,差异均有统计学意义(P﹤0.05)。B组患者切口感染、肠梗阻发生率均低于A组,尿漏发生率高于A组,差异均有统计学意义(P﹤0.05)。结论腹腔镜膀胱全切术后采取回肠通道术、输尿管皮肤造口术各有优劣,其中输尿管皮肤造口术可减轻膀胱癌患者的应激反应,促进患者术后恢复。Objective To investigate the application effect of ileal conduit and ureterocutaneostomy after laparoscopic total cystotomy in patients with bladder cancer.Method A total of 80 patients with bladder cancer were divided into group A(n=39,received ileal conduit)and group B(n=41,received ureterocutaneostomy)according to different ways of urinary diversion after laparoscopic total cystotomy.The surgery-related indexes,stress response indexes[cortisol(Cor),epinephrine(E)and norepinephrine(NE)]and complications were compared between the two groups.Result The intraoperative blood loss in group B was significantly less than that in group A,the operation time,intestinal function recovery time and hospital stay were significantly shorter than those in group A,and the differences were statistically significant(P<0.01).After surgery,the levels of NE,E and Cor in both groups were lower than those before surgery,and the levels of NE,E and Cor in group B were lower than those in group A,the differences were statistically significant(P<0.05).The incidences of incision infection and intestinal obstruction in group B were lower than those in group A,and the incidence of urinary leakage was higher than that in group A,the differences were statistically significant(P<0.05).Conclusion Both ileal conduit and ureterocutaneostomy after laparoscopic total cystotomy have their advantages and disadvantages.Among them,ureterocutaneostomy can reduce the stress response of patients with bladder cancer and promote postoperative recovery.

关 键 词：膀胱癌 腹腔镜膀胱全切术 回肠通道术 输尿管皮肤造口术 应激反应 

分 类 号：R737.14[医药卫生—肿瘤]