中华老年医学杂志
中華老年醫學雜誌
중화노년의학잡지
Chinese Journal of Geriatrics
2011年
5期
387-389
,共3页
王绍勇%宋鸿彬%周春文%林海群
王紹勇%宋鴻彬%週春文%林海群
왕소용%송홍빈%주춘문%림해군
膀胱肿瘤%尿流改道术%尿动力学
膀胱腫瘤%尿流改道術%尿動力學
방광종류%뇨류개도술%뇨동역학
Bladder neoplasms%Carcinoma Bladder reconstruction%Urodynamics
目的 探讨应用尿动力学方法评估回盲结肠膀胱原位重建术在老年膀胱癌患者中的应用价值.方法 应用回盲肠及部分升结肠作储尿囊,以阑尾根部与后尿道吻合原位排尿的方法治疗膀胱肿瘤患者12例,应用尿动力学方法对其近期疗效进行随访.结果 12例中11例患者能达到完全控尿,1例有尿失禁,3例有夜间尿失禁.多数患者能达到控尿目的.术后3个月内白天排尿次数8~10次,夜间3~5次;6个月后白天平均4~6次,夜间0~2次.每次量约150~350 ml.术后6个月~1年分别随访12例患者.尿动力学结果显示:平均尿流率10.5 ml/s,平均膀胱初始感觉压力27 cm H2O(1 cm H2O=0.098 kPa),最大充盈压35 cm H2O,其储尿囊容量分别为152 ml、420 ml.后尿道闭合压力为52 cm H2O,残余尿量0~65 ml.结论 正位膀胱重建术具有储尿囊内压低、容量大、可控性和原位排尿的特点,是一种较理想的尿流改道方式.
目的 探討應用尿動力學方法評估迴盲結腸膀胱原位重建術在老年膀胱癌患者中的應用價值.方法 應用迴盲腸及部分升結腸作儲尿囊,以闌尾根部與後尿道吻閤原位排尿的方法治療膀胱腫瘤患者12例,應用尿動力學方法對其近期療效進行隨訪.結果 12例中11例患者能達到完全控尿,1例有尿失禁,3例有夜間尿失禁.多數患者能達到控尿目的.術後3箇月內白天排尿次數8~10次,夜間3~5次;6箇月後白天平均4~6次,夜間0~2次.每次量約150~350 ml.術後6箇月~1年分彆隨訪12例患者.尿動力學結果顯示:平均尿流率10.5 ml/s,平均膀胱初始感覺壓力27 cm H2O(1 cm H2O=0.098 kPa),最大充盈壓35 cm H2O,其儲尿囊容量分彆為152 ml、420 ml.後尿道閉閤壓力為52 cm H2O,殘餘尿量0~65 ml.結論 正位膀胱重建術具有儲尿囊內壓低、容量大、可控性和原位排尿的特點,是一種較理想的尿流改道方式.
목적 탐토응용뇨동역학방법평고회맹결장방광원위중건술재노년방광암환자중적응용개치.방법 응용회맹장급부분승결장작저뇨낭,이란미근부여후뇨도문합원위배뇨적방법치료방광종류환자12례,응용뇨동역학방법대기근기료효진행수방.결과 12례중11례환자능체도완전공뇨,1례유뇨실금,3례유야간뇨실금.다수환자능체도공뇨목적.술후3개월내백천배뇨차수8~10차,야간3~5차;6개월후백천평균4~6차,야간0~2차.매차량약150~350 ml.술후6개월~1년분별수방12례환자.뇨동역학결과현시:평균뇨류솔10.5 ml/s,평균방광초시감각압력27 cm H2O(1 cm H2O=0.098 kPa),최대충영압35 cm H2O,기저뇨낭용량분별위152 ml、420 ml.후뇨도폐합압력위52 cm H2O,잔여뇨량0~65 ml.결론 정위방광중건술구유저뇨낭내압저、용량대、가공성화원위배뇨적특점,시일충교이상적뇨류개도방식.
Objective To evaluate the effect of the urinary reservoir constructed with ileocecum-appendix in the elderly with bladder cancer. Methods From March 2002 to June 2008, 12 cases were treated using ileocecum-appendix as the reservoir after radical cystectomy. They all received the imaging urodynamics examination and were followed up for 1 year. Results The 11 of 12 patients had urinary continence completely. Only 1 case had incontinence and 3 cases had incontinentia urinae at night. Times of uresis were 8-10/day and 3-5/night within 3 months after surgery, and 4-6/day and 0-2/night 6 months after surgery. The urinary output was 150-350 ml/time. Urodynamics showed that mean urinary flow rate was 10.5 ml/s, mean initial bladder pressure was 27 cm H2O, the maximum filling pressure was 35 cm H2O. The average reservoir capacity was 152 ml and 420 ml, respectively. The out let pressure of posterior urethra was 52 cm H2O. The volume of residual urine was 0-65 ml. No evidence of ureteral reflux occurred, no hyperchloremic acidosis was observed. Conclusions Orthotopic bladder reconstruction is considered as an ideal form of urinary diversion characterized by low pressure, larger capacity and continence.