国际外科学杂志
國際外科學雜誌
국제외과학잡지
INTERNATIONAL JOURNAL OF SURGERY
2012年
10期
660-662
,共3页
马永图%贺艳锋%张建斌%王军才%李占琦%冯建明%赵少雄%王辉
馬永圖%賀豔鋒%張建斌%王軍纔%李佔琦%馮建明%趙少雄%王輝
마영도%하염봉%장건빈%왕군재%리점기%풍건명%조소웅%왕휘
尿道改流术%膀胱肿瘤%上尿路%功能恢复
尿道改流術%膀胱腫瘤%上尿路%功能恢複
뇨도개류술%방광종류%상뇨로%공능회복
Urinary diversion%Urinary bladder neoplasms%Upper urinary%Recovery of function
目的 探讨膀胱癌行膀胱全切原位回肠膀胱术后,新膀胱对上尿路功能的影响.方法 评估2006年3月-2010 年6月陕西省核工业二一五医院泌尿外科收治的28例肌层浸润性膀胱尿路上皮癌行膀胱全切W形原位回肠代膀胱患者的上尿路功能,所有病例随访2年以上.评估项目包括肌酐测定、泌尿系B超测定膀胱残余尿量及肾积水量、膀胱造影明确有无尿液反流.结果 术后4周拔除导尿管之前行膀胱造影检查,未发现明显造影剂外溢,术后3个月轻度肾积水8例(28.6％),其中2例(7.1％)术前即合并有肾积水,x2 =0.49 (P ＞0.05),差异无统计学意义.术后2年轻度肾积水5例(17.9％),与术前比较,x2 =0.22(P ＞0.05)差异无统计学意义.术前血肌酐(72.92±14.58) mmol/L,术后3个月血肌酐(83.42±15.18) mmol/L,t=-6.43(P ＜0.05),手术前后血肌酐均值均在正常值范围,术后2年血肌酐(82.50±14.39) mmol/L,与术前比较,t=-4.67 (P＜0.05),但均在正常范围,无临床意义.术后3个月膀胱容量(160±23) mL,残余尿量(58.7 ±9.7) mL,术后2年膀胱容量(430±21) mL,残余尿量(61.3 ±37.1)mL,t=-0.37(P＞0.05),差异无统计学意义.结论 原位W型回肠膀胱可作为膀胱全切术后较为理想的待膀胱术式,对上尿路功能影响较轻.
目的 探討膀胱癌行膀胱全切原位迴腸膀胱術後,新膀胱對上尿路功能的影響.方法 評估2006年3月-2010 年6月陝西省覈工業二一五醫院泌尿外科收治的28例肌層浸潤性膀胱尿路上皮癌行膀胱全切W形原位迴腸代膀胱患者的上尿路功能,所有病例隨訪2年以上.評估項目包括肌酐測定、泌尿繫B超測定膀胱殘餘尿量及腎積水量、膀胱造影明確有無尿液反流.結果 術後4週拔除導尿管之前行膀胱造影檢查,未髮現明顯造影劑外溢,術後3箇月輕度腎積水8例(28.6％),其中2例(7.1％)術前即閤併有腎積水,x2 =0.49 (P ＞0.05),差異無統計學意義.術後2年輕度腎積水5例(17.9％),與術前比較,x2 =0.22(P ＞0.05)差異無統計學意義.術前血肌酐(72.92±14.58) mmol/L,術後3箇月血肌酐(83.42±15.18) mmol/L,t=-6.43(P ＜0.05),手術前後血肌酐均值均在正常值範圍,術後2年血肌酐(82.50±14.39) mmol/L,與術前比較,t=-4.67 (P＜0.05),但均在正常範圍,無臨床意義.術後3箇月膀胱容量(160±23) mL,殘餘尿量(58.7 ±9.7) mL,術後2年膀胱容量(430±21) mL,殘餘尿量(61.3 ±37.1)mL,t=-0.37(P＞0.05),差異無統計學意義.結論 原位W型迴腸膀胱可作為膀胱全切術後較為理想的待膀胱術式,對上尿路功能影響較輕.
목적 탐토방광암행방광전절원위회장방광술후,신방광대상뇨로공능적영향.방법 평고2006년3월-2010 년6월합서성핵공업이일오의원비뇨외과수치적28례기층침윤성방광뇨로상피암행방광전절W형원위회장대방광환자적상뇨로공능,소유병례수방2년이상.평고항목포괄기항측정、비뇨계B초측정방광잔여뇨량급신적수량、방광조영명학유무뇨액반류.결과 술후4주발제도뇨관지전행방광조영검사,미발현명현조영제외일,술후3개월경도신적수8례(28.6％),기중2례(7.1％)술전즉합병유신적수,x2 =0.49 (P ＞0.05),차이무통계학의의.술후2년경도신적수5례(17.9％),여술전비교,x2 =0.22(P ＞0.05)차이무통계학의의.술전혈기항(72.92±14.58) mmol/L,술후3개월혈기항(83.42±15.18) mmol/L,t=-6.43(P ＜0.05),수술전후혈기항균치균재정상치범위,술후2년혈기항(82.50±14.39) mmol/L,여술전비교,t=-4.67 (P＜0.05),단균재정상범위,무림상의의.술후3개월방광용량(160±23) mL,잔여뇨량(58.7 ±9.7) mL,술후2년방광용량(430±21) mL,잔여뇨량(61.3 ±37.1)mL,t=-0.37(P＞0.05),차이무통계학의의.결론 원위W형회장방광가작위방광전절술후교위이상적대방광술식,대상뇨로공능영향교경.
Objective To explore bladder carcinoma eystectomy and orthotopic ileal neobladder postoperative,the impact of new bladder on upper urinary function.Methods Twenty-eight patients with muscle invasive bladder urothelial carcinoma undergoing cystectomy W-shaped orthotopic ileal neobladder in Department of Urology of the Nuclear Industry 215 Hospital of Shaanxi Province(Mar.2006-Jun.2010)were investigated.All patients were followed for over 2 years.Assessment items included creatinine determination,urinary B-Ultrasound determination of the amount of residual urine volume and hydronephrotic cystography.Results Four weeks after the operations,all patients were removed bladder catheter angiography and found no obvious contrast extravasation.After 3 months mild hydronephrosis was found in 8 cases (28.6％),including 2 cases (7.1％) before surgery associated with hydronephrosis,the difference being not statistically significant(x2=0.49,P ＞ 0.05).The mild hydronephrosis was found in 5 cases (17.9％) 2 years postoperation,whithout statistically significant difference compared with preoperation (x2 =0.22,P ＞ 0.05).Preoperative serum creatinine was (72.92 ± 14.58) mmol/L,while 3 months after surgery serum creatinine was (83.42 ± 15.18) mmol/L (t =-6.43,P ＜ 0.05).Preoperative and postoperative serum creatinine was within the normal range.Two years after surgery serum creatinine was (82.50 ± 14.39) mmol/L,with significant difference compared with that of preoperation (t =-4.67,P ＜ 0.05),but were in the normal range,no clinical significance,the postoperative 3 months bladder capacity (160 ± 23) mL,while 2 years later bladder capacity residual urine volume of (58.7 ± 9.7) mL and (430 ± 21) mL,residual urine volume (61.3 ± 37.1) mL(t =-0.37,P＞ 0.05).Conclusion Orthotopie ileal bladder ideal substitute for postoperative cystectomy with less impact on the upper urinary tract function.
