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目的:比较、分析根治性全膀胱术后,原位回肠和乙状结肠新膀胱的尿动力学结果,为选择更为理想的新膀胱提供依据。方法:2002年1月～2009年6月间,将60例浸润性膀胱癌患者随机行根治性全膀胱切除、原位回肠新膀胱术(A组,男29例,女1例,平均54岁)和根治性全膀胱切除、原位乙状结肠新膀胱术(B组,男28例,女2例,平均55岁)。术后18～24个月比较分析两组患者储尿囊及流出道的尿动力学检查结果。结果:储尿囊最大容量、储尿囊最大内压、最大尿流率、剩余尿量、昼尿可控率、夜尿可控率A组分别为(556.0±110.5)ml、(1.695±0.598)kPa、(18.2±2.3)ml/s、(81.3±3.3)ml、90.0%、83.3%;B组分别为(410.2±90.2)ml、(1.784±0.843)kPa、(17.3±2.8)ml/s、(79.3±4.3)ml、86.7%、80.0%。两组储尿囊最大容量差异有统计学意义(P<0.05),储尿囊最大内压、剩余尿量、最大尿流率、昼使尿可控率差异无统计学意义(P>0.05)。结论两种术式术后均获得较好的控尿和排尿疗效,术者可以根据肠系膜的长短,擅长的手术方式选择新膀胱的方法。
OBJECTIVE: To compare and analyze the urodynamic results of primary ileal and sigmoid neo-bladder after radical total bladder surgery and provide the basis for choosing a more ideal neo-bladder. Methods: From January 2002 to June 2009, 60 patients with invasive bladder cancer were randomly divided into radical total cystectomy and radical ileal neo-bladder surgery (group A, 29 males and 1 females with an average age of 54 years ) And radical total cystectomy in situ sigmoid neo-bladder surgery (group B, 28 males and 2 females, mean 55 years). 18 months to 24 months after operation were compared urinalysis of the two groups of patients and outflow tract urodynamic test results. Results: The maximal storage capacity, the maximal internal pressure of storage and storage, the maximal urinary flow rate, the residual urine volume, the controllable rate of daytime urine and the controllable rate of nocturia were (556.0 ± 110.5) ml and (1.695 ± 0.598 ) were significantly higher in group B than in group B (410.2 ± 90.2) ml, (1.784 ± 0.843) kPa, (17.3 ± 2.8) ml / s, (79.3 ± 4.3) ml, 86.7%, 80.0%. The maximal internal pressure, residual urine volume, maximal uroflow rate and diurnal urinary control rate were not significantly different between the two groups (P <0.05) . Conclusion Both of the two procedures have better control effects on urinary bladder and urination. The surgeon can select the new bladder according to the length of the mesentery and good surgical operation.