發(fā)布時間：2018-10-14 14:03

【摘要】：目的：探討分析全膀胱切除后原位回腸新膀胱術(shù)與回腸膀胱術(shù)臨床療效差異方法：學(xué)習(xí)膀胱癌的診斷和治療相關(guān)文獻(xiàn)，回顧分析2008年1月至2012年6月安徽省立醫(yī)院泌尿外科67例膀胱癌全膀胱切除患者的臨床資料，其中行原位回腸新膀胱術(shù)35例（新膀胱組,1組），行回腸膀胱術(shù)32例（回腸膀胱組，2組）。統(tǒng)計手術(shù)中出血量、手術(shù)時間、腸道功能恢復(fù)時間、住院時間，觀察早期并發(fā)癥，如漏尿、腸梗阻、切口感染、電解質(zhì)紊亂等。術(shù)后每三個月及一年后每半年定期隨訪復(fù)查血常規(guī)及生化，泌尿系、盆腔及腹膜后B超。查看腫瘤復(fù)發(fā)轉(zhuǎn)移、腎積水、繼發(fā)尿囊結(jié)石等晚期并發(fā)癥情況。數(shù)據(jù)經(jīng)SPSS19.0軟件進行統(tǒng)計分析，，計量資料（均數(shù)±標(biāo)準(zhǔn)差），采用t檢驗；計數(shù)資料使用卡方檢驗或Fishers精確概率法，以P0.05為差異有統(tǒng)計學(xué)意義。 結(jié)果：原位回腸新膀胱術(shù)較回腸膀胱術(shù)手術(shù)時間久、術(shù)中出血多、住院時間長，兩種術(shù)式的腸道功能恢復(fù)時間及早晚期手術(shù)并發(fā)癥差異無統(tǒng)計學(xué)意義，原位回腸新膀胱術(shù)適應(yīng)癥不如回腸膀胱術(shù)廣泛，但術(shù)后患者可自主控制排尿，術(shù)后生活質(zhì)量高于回腸膀胱術(shù)。 結(jié)論：原位回腸膀胱術(shù)與回腸膀胱術(shù)各有優(yōu)點，泌尿外科醫(yī)生需與病人充分溝通并告知尿流改道的各種手術(shù)方式及其優(yōu)缺點，更適宜的服務(wù)于患者。
[Abstract]:Objective: to investigate the difference of clinical efficacy between in situ ileal neobladder and ileal cystectomy after total cystectomy. Methods: to study the literature on the diagnosis and treatment of bladder cancer. From January 2008 to June 2012, the clinical data of 67 patients with total cystectomy of bladder cancer in the Department of Urology, Anhui Provincial Hospital, were retrospectively analyzed. 35 cases were treated with in situ ileal neobladder (group 1) and 32 cases with ileal bladder (group 2). The bleeding volume, operation time, intestinal function recovery time, hospitalization time, early complications such as urine leakage, intestinal obstruction, incision infection, electrolyte disturbance and so on were analyzed. Blood routine and biochemical, urinary, pelvic and retroperitoneal B ultrasound were followed up every three months and one year after operation. Check tumor recurrence and metastasis, hydronephrosis, secondary allantolithiasis and other late complications. The data were statistically analyzed by SPSS19.0 software, the measurement data (mean 鹵standard deviation) were measured by t test, and the counting data were calculated by chi-square test or Fishers accurate probability method, with P0.05 as the difference. Results: the in situ ileal neobladder operation was longer than that of ileal bladder operation, with more bleeding and longer hospital stay. There was no significant difference in the recovery time of intestinal function between the two operations. The indication of orthotopic ileal neobladder is not as wide as that of ileal cystectomy, but the postoperative patients can control urination autonomously, and the quality of life after operation is higher than that of ileal cystectomy. Conclusion: in situ ileal cystectomy and ileal cystectomy have respective advantages. Urologists should communicate fully with the patients and inform them of the various surgical methods of urinary diversion and their advantages and disadvantages so as to better serve the patients.
【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R737.14

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 湯召兵;茍欣;王明;何衛(wèi)陽;陳在賢;劉朝東;;原位胃代膀胱與原位回腸代膀胱的比較研究[J];第三軍醫(yī)大學(xué)學(xué)報;2010年10期

2 黃錦華,李泗耀;膀胱鏡、B超、尿脫落細(xì)胞學(xué)檢查在膀胱癌診斷的評價[J];廣州醫(yī)學(xué)院學(xué)報;2003年02期

3 郁華亮;葉林陽;楊渝;林茂虎;朱曉應(yīng);吳元翼;;全膀胱切除術(shù)后不同尿流改道方式的療效比較[J];醫(yī)學(xué)臨床研究;2008年10期

4 李柏均;李陸安;陸州;高志遠(yuǎn);農(nóng)禮銘;余和恒;;根治性膀胱全切去帶乙狀結(jié)腸原位新膀胱術(shù)的臨床研究[J];吉林醫(yī)學(xué);2011年03期

5 黃健;早期膀胱癌的診治探討[J];交通醫(yī)學(xué);2001年05期

6 程文君;袁建軍;李軍苗;馬路遙;陳潔;;MRI在膀胱癌診斷和分期中的應(yīng)用價值[J];浙江臨床醫(yī)學(xué);2007年12期

7 周榮祥,曹洪玲,張宗亮;尿流改道及膀胱重建術(shù)的現(xiàn)狀與展望[J];現(xiàn)代泌尿外科雜志;2005年03期

8 湯海;唐涌志;陳向東;丁滿棠;張文鼎;肖軍;;膀胱內(nèi)不同化療藥物灌注預(yù)防淺表型膀胱腫瘤復(fù)發(fā)的臨床觀察[J];現(xiàn)代泌尿外科雜志;2008年01期

9 馮寧翰;王增軍;宋寧宏;楊杰;劉敏;吳宏飛;眭元庚;張煒;顧民;華立新;;原位回腸新膀胱手術(shù)的臨床研究[J];南京醫(yī)科大學(xué)學(xué)報(自然科學(xué)版);2009年09期

10 張心如;喬勇;谷寶軍;金三寶;陳嶸;金重睿;司捷e

本文編號：2270693