根治性膀胱切除术联合回肠原位新膀胱术在膀胱癌患者中的应用(1)
[摘要]目的 研究根治性膀胱切除术联合回肠原位新膀胱术在膀胱癌患者中的应用效果。方法 选取我院2017年7月～2018年5月收治的80例膀胱癌患者为研究对象，按随机数字表法将患者分为试验组(40例)和对照组(40例)。给予对照组患者根治性膀胱切除术加乙状结肠原位新膀胱术，试验组患者给予根治性膀胱切除术加回肠原位新膀胱术。比较两组患者术后2、4个月排尿期尿动力检查结果、患者术后膀胱充盈期尿動力检查结果、患者术后膀胱功能。结果 试验组患者术后4个月的排尿期最大腹压、最大逼尿肌压和最大膀胱内压高于对照组，差异均有统计学意义(P<0.05);试验组患者术后4个月的充盈期膀胱顺应性高于对照组，膀胱基础压和膀胱充盈状态内压低于对照组，差异均有统计学意义(P<0.05);两组术后4个月的新膀胱容量、残余尿和最大尿流率比较，差异无统计学意义(P>0.05)。结论 回肠原位新膀胱术较乙状结肠原位新膀胱术应用于根治性膀胱切除术后更具优势，能有效促进患者术后膀胱顺应性、最大逼尿肌压，提高患者日夜间控尿率。
[关键词]根治性膀胱切除术;乙状结肠原位新膀胱术;回肠原位新膀胱术;膀胱癌
[中图分类号] R730.56 [文献标识码] A [文章编号] 1674-4721(2020)4(a)-0077-03
[Abstract] Objective To study the application effect of radical cystectomy combined with ileal orthotopic neobladder in patients with bladder cancer. Methods A total of 80 cases of bladder cancer patients treated in our hospital from July 2017 to May 2018 were selected as the research subjects. The patients were divided into an experimental group (n=40) and a control group (n=40) according to the random number table method. Patients in the control group received radical cystectomy combined with sigmoid orthotopic neobladder， and patients in the experimental group received radical cystectomy combined with ileal orthotopic neobladder. The results of urinary dynamic examination 2 and 4 months after operation the results of urodynamic examination during bladder filling as well as the bladder function were compared between the two groups. Results The maximum abdominal pressure， maximum detrusor pressure， and maximum bladder pressure during the urination period in the experimental group were higher than those in the control group， and the differences were statistically significant (P<0.05). The bladder compliance during the filling period was higher than that of the control group. The bladder pressure and internal pressure of the bladder filling were lower than those of the control group， and the differences were statistically significant (P<0.05). There were no significant differences in neobladder capacity， residual urine and maximum urine flow rate between the two groups (P>0.05). Conclusion Compared with the sigmoid orthotopic neobladder， the ileal orthotopic neobladder has many more advantages after radical cystectomy. It can effectively promote postoperative bladder compliance， increase the maximum detrusor muscle pressure， and the rate of day and night urine control.
[Key words] Radical cystectomy; Sigmoid orthotopic neobladder; Ileal orthotopic neobladder; Bladder cancer, http://www.100md.com(余祖辉 陈丙辰 伍晓文)
[关键词]根治性膀胱切除术;乙状结肠原位新膀胱术;回肠原位新膀胱术;膀胱癌
[中图分类号] R730.56 [文献标识码] A [文章编号] 1674-4721(2020)4(a)-0077-03
[Abstract] Objective To study the application effect of radical cystectomy combined with ileal orthotopic neobladder in patients with bladder cancer. Methods A total of 80 cases of bladder cancer patients treated in our hospital from July 2017 to May 2018 were selected as the research subjects. The patients were divided into an experimental group (n=40) and a control group (n=40) according to the random number table method. Patients in the control group received radical cystectomy combined with sigmoid orthotopic neobladder， and patients in the experimental group received radical cystectomy combined with ileal orthotopic neobladder. The results of urinary dynamic examination 2 and 4 months after operation the results of urodynamic examination during bladder filling as well as the bladder function were compared between the two groups. Results The maximum abdominal pressure， maximum detrusor pressure， and maximum bladder pressure during the urination period in the experimental group were higher than those in the control group， and the differences were statistically significant (P<0.05). The bladder compliance during the filling period was higher than that of the control group. The bladder pressure and internal pressure of the bladder filling were lower than those of the control group， and the differences were statistically significant (P<0.05). There were no significant differences in neobladder capacity， residual urine and maximum urine flow rate between the two groups (P>0.05). Conclusion Compared with the sigmoid orthotopic neobladder， the ileal orthotopic neobladder has many more advantages after radical cystectomy. It can effectively promote postoperative bladder compliance， increase the maximum detrusor muscle pressure， and the rate of day and night urine control.
[Key words] Radical cystectomy; Sigmoid orthotopic neobladder; Ileal orthotopic neobladder; Bladder cancer, http://www.100md.com(余祖辉 陈丙辰 伍晓文)
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