论文部分内容阅读
目的比较经腹腔镜手术与开放手术治疗原发性膀胱憩室的临床效果。方法回顾性分析2009年9月至2016年7月收治的22例原发性膀胱憩室患者的临床资料,分为开放手术组12例,腹腔镜手术组10例。采用两独立样本均数t检验,比较两组患者手术时间及术中出血量。采用配对t检验,分别比较两组患者术前、术后排尿时膀胱压力及尿流率结果。采用两独立样本均数近似t检验,比较两组患者术前、术后排尿时膀胱压力及尿流率数值变化。结果腹腔镜手术组较开放手术组手术时间延长(P<0.05),出血量减少(P<0.05)。开放手术组术后随访(13.6±4.0)个月,腹腔镜手术组术后随访(13.6±5.7)个月。两组患者术后排尿时膀胱压力均较术前降低(P<0.05);术后最大尿流率均较术前增加(P<0.05)。术后患者尿流曲线改善。比较两组患者术前、术后排尿时膀胱压力及尿流率数值变化,差异均无统计学意义(P>0.05)。术后均未再出现膀胱输尿管返流,无膀胱憩室复发,排尿正常,未再出现排尿困难。结论经腹腔镜切除原发性膀胱憩室,手术创伤小,出血少,与开放手术效果无明显差异,是理想的微创手术方式。
Objective To compare the clinical effects of laparoscopic surgery and open surgery for primary bladder diverticulum. Methods The clinical data of 22 patients with primary bladder diverticulum admitted from September 2009 to July 2016 were retrospectively analyzed. They were divided into open surgery group (n = 12) and laparoscopic surgery group (n = 10). Two independent samples mean t test was used to compare the operation time and intraoperative blood loss in both groups. Paired t-test was used to compare the bladder pressure and urinary flow rate before and after urination in both groups. Two independent samples mean t test was used to compare the two groups of patients before and after urination bladder pressure and urinary flow rate changes. Results Compared with open surgery group, laparoscopic surgery group had longer operation time (P <0.05) and less bleeding (P <0.05). The patients in the open surgery group were followed up for 13.6 ± 4.0 months. The patients in the laparoscopic surgery group were followed up for 13.6 ± 5.7 months. The urinary bladder pressure was lower in both groups after operation than that before operation (P <0.05). The maximum urinary flow rate after operation was higher than that before operation (P <0.05). Postoperative urinary flow curve improved. Comparing the changes of bladder pressure and urinary flow rate in both groups before and after urination, the difference was not statistically significant (P> 0.05). No recurrence of vesicoureteral reflux, no bladder diverticulum recurrence, normal urination, dysuria no longer occurred. Conclusion Laparoscopic resection of the primary bladder diverticulum, less trauma, less bleeding, and no significant difference between the open surgery, is the ideal minimally invasive surgical approach.