CAJ | 학술논문

目的探讨球形可控回肠原位膀胱术的尿动力学特点和临床效果.方法 1999年1月至2008年6月行球形可控回肠原位新膀胱术48例,对其中26例男性患者(膀胱移行细胞癌20例,移行细胞癌部分鳞化4例,移行细胞癌伴腺癌及鳞癌1例,移行细胞癌伴隐匿前列腺腺癌1例)进行尿动力学随访.统计学比较患者术后3～12个月新膀胱压力、容积、尿道压和尿流率等指标.结果术后6个月26例患者新膀胱容量400 ml时基本压力＜15 cm H2O(1 cm H2O=0.098 kPa),膀胱完全充盈时平均压力为18.2 cm H2O.新膀胱平均收缩压＜40 cm H2O.术后膀胱充盈期压力比较:3个月与6个月t=3.03,P＜0.05;6个月与9个月t=0.54,P＞0.05;9个月与12个月t=1.27,P＞0.05;平均残余尿42 ml.Valsalva动作排尿,排尿峰值平均19.6 ml/s.术后平均4.5个月患者昼夜控尿率分别为92%(24/26)和65%(17/26).结果球形可控回肠膀胱术所需肠管短、容量大、压力低、可控性好,是原位膀胱重建的良好术式.
목적 탐토구형가공회장원위방광술적뇨동역학특점화림상효과.방법 1999년1월지2008년6월행구형가공회장원위신방광술48례,대기중26례남성환자(방광이행세포암20례,이행세포암부분린화4례,이행세포암반선암급린암1례,이행세포암반은닉전렬선선암1례)진행뇨동역학수방.통계학비교환자술후3～12개월신방광압력、용적、뇨도압화뇨류솔등지표.결과 술후6개월26례환자신방광용량400 ml시기본압력＜15 cm H2O(1 cm H2O=0.098 kPa),방광완전충영시평균압력위18.2 cm H2O.신방광평균수축압＜40 cm H2O.술후방광충영기압력비교:3개월여6개월t=3.03,P＜0.05;6개월여9개월t=0.54,P＞0.05;9개월여12개월t=1.27,P＞0.05;평균잔여뇨42 ml.Valsalva동작배뇨,배뇨봉치평균19.6 ml/s.술후평균4.5개월환자주야공뇨솔분별위92%(24/26)화65%(17/26).결과 구형가공회장방광술소수장관단、용량대、압력저、가공성호,시원위방광중건적량호술식.
Objective To evaluate the urodynamic and functional characteristics of 26 patients who had underwent orthotopic contient globular ileal neobladder. Methods The clinical date of 26patients who underwent radical cystectomy were reviewed. The neobladder pressure, capacity, urethral pressure and urinary flow rate were collected at 3-12 months after operation. Results The neobladders average pressure was less than 15 cm H2O when the volume was 400 ml. The pressure was 22.4 cm H2O at 100% capacity. The mean pressure of contractions was less than 40 cm H2O. The mean filling pressure after operation was relative stable while the difference between 3 months and 6 months was statistically significant. The difference between 6 and 9 and 12 month showed no statistical significance. The mean post-void residual was 42 ml. A mean voiding flow rate of 19. 6 ml/s could be obtained by Valsalva. Conclusion The neobladder not only could offer adequate capacity at low pressures but also could give a satisfied continent.