目的　探讨膀胱肿瘤患者膀胱全切术后行回肠代膀胱术与回肠膀胱术的临床治疗效果及术后早期并发症。方法　分析 13 5例膀胱肿瘤患者行膀胱全切术后采用回肠代膀胱术 86例与回肠膀胱术 49例的临床资料 ,就两种术式手术时间、术中出血量、术后早期并发症、平均住院日、再手术率及死亡率等指标进行比较分析。结果　除手术操作时间回肠代膀胱术组 (平均 3 46min)长于回肠膀胱术组 (平均 2 70min)外 ,回肠代膀胱与回肠膀胱术组在术中平均出血量 (660ml与 62 7ml)、术后早期并发症发生率 (18.6%与 16.3 % )、患者平均住院日 (4 7d与 41d)、再手术率 (8.1%与6.1% )及死亡率 (1.2 %与 2 .0 % )等方面差异无显著性 (P >0 .0 5 )。结论　回肠代膀胱术是膀胱全切术后膀胱替代的理想术式 ,具有手术安全 ,术后早期并发症少 ,可自主性控制排尿 ,明显提高患者的生活质量而易于接受 ,是值得推荐的膀胱替代手术方式 Objective To investigate the clinical effects of ileal neobladder and ileal bladder surgery after bladder resection in patients with bladder cancer and early postoperative complications. Methods The clinical data of 86 cases with ileal neobladder and 49 cases with ileal bladder were retrospectively analyzed in 135 cases of bladder cancer after operation. The operative time, intraoperative blood loss, early postoperative complications, Average length of stay, rate of reoperation and mortality and other indicators for comparative analysis. Results The average intraoperative blood loss (660ml vs 627ml) in the ileal bladder and ileal bladder surgery group was significantly higher than that in the ileal bladder surgery group (mean 466min) and ileal bladder surgery group (mean 270mm) The incidences of early complications (18.6% vs 16.3%), average length of hospital stay (47 days vs 41 days), reoperation rates (8.1% vs 6.1%) and death rates (1.2% vs 2.0% Significance (P> 0.05). Conclusions The ileal neobladder is an ideal surgical method for bladder replacement after total mastectomy. It is safe and safe to operate. It has less postoperative early complications and can control urination autonomously. It can improve the quality of life of patients and is easy to accept. It is a recommendable bladder Alternative surgical methods