本文關鍵詞： 尿流改道術(shù) 生活質(zhì)量 膀胱切除術(shù) 微創(chuàng)　出處：《中國內(nèi)鏡雜志》2017年06期 　論文類型：期刊論文

【摘要】：目的 探討膀胱癌患者微創(chuàng)切除術(shù)后不同尿流改道方案的臨床效果。方法 選取2010年1月-2015年6月該院泌尿科收治的肌層浸潤型膀胱癌患者127例,根據(jù)患者的病情接受不同的尿流改道方案,將患者分為原位回腸膀胱術(shù)組58例,Bricker膀胱術(shù)組33例,輸尿管皮膚造口術(shù)組36例,比較3組患者一般資料、臨床資料、術(shù)后并發(fā)癥和生活質(zhì)量評分。結(jié)果 3組患者的性別比例、年齡分布以及腫瘤分期的差異無統(tǒng)計學意義;手術(shù)時間和術(shù)后住院時間,原位回腸膀胱術(shù)組長于其他兩組,Bricker膀胱術(shù)組長于輸尿管皮膚造口術(shù)組,差異均具有統(tǒng)計學意義;術(shù)中出血量,原位回腸膀胱術(shù)組多于其他兩組,Bricker膀胱術(shù)組多于輸尿管皮膚造口術(shù)組,差異均具有統(tǒng)計學意義,兩兩比較腸功能恢復時間,原位回腸膀胱術(shù)組與Bricker膀胱術(shù)組差異無統(tǒng)計學意義,輸尿管皮膚造口術(shù)組時間短于其他兩組,差異具有統(tǒng)計學意義;3組患者近期并發(fā)癥發(fā)生率的比較,差異無統(tǒng)計學意義;原位回腸膀胱術(shù)組的遠期并發(fā)癥總比例明顯高于其他兩組,差異具有統(tǒng)計學意義;原位回腸膀胱術(shù)組患者社會功能評分、總體健康評分高于其他兩組,差異具有統(tǒng)計學意義。結(jié)論 原位回腸膀胱術(shù)無需外接裝置,更接近生理排尿特征,術(shù)后生活質(zhì)量較高,但是遠期并發(fā)癥發(fā)生率較高,輸尿管皮膚造口術(shù)后恢復快,并發(fā)癥較少,適應不宜長時間手術(shù)的患者。應根據(jù)患者個體狀況選擇合適的手術(shù)方式。
[Abstract]:Objective to investigate the clinical effect of different urinary diversion schemes in patients with bladder cancer after minimally invasive resection. Methods 127 patients with myometrial invasive bladder cancer treated in our department of urology from January 2010 to June 2015 were selected. According to different urinary diversion schemes, patients were divided into two groups: in situ ileal cystectomy group (n = 58), Bricker cystectomy group (n = 33) and ureteral dermatostomy group (n = 36). Results there were no significant differences in sex ratio, age distribution and tumor staging among the three groups. In situ ileal cystectomy and Bricker cystectomy in the other two groups in ureteral dermatostomy group, the difference was statistically significant. The in situ ileal cystectomy group was more than the other two groups, the difference was statistically significant. There was no significant difference between in situ ileal cystectomy group and Bricker cystectomy group. The time of ureterostomy group was shorter than that of the other two groups, the difference was statistically significant. The total proportion of long-term complications in the in situ ileal bladder operation group was significantly higher than that in the other two groups, the difference was statistically significant, the social function score and the overall health score of the patients in the in situ ileal bladder operation group were higher than those in the other two groups. Conclusion the in situ ileal bladder operation is more close to the physiological urination characteristics, and the quality of life is higher after operation, but the incidence of long-term complications is higher, and the recovery of ureteral dermatostomy is faster. The patients with less complications and unsuitable for long-term operation should choose the appropriate operation method according to the individual condition of the patients.
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本文編號：1517447