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目的探讨改良可控性回肠膀胱临床应用的效果。方法膀胱癌行根治性膀胱切除尿流改道患者12例,采用改良的回肠乳头瓣作为输出道,外口与脐孔作皮瓣嵌入防狭窄吻合,去管化回肠浆膜下隧道抗返流技术。结果12例随访14~50个月,昼夜控尿满意,尿动力学显示:储尿囊容量350~720(435±88)m l,充盈时内压15~32(20±5)cm H2O,储尿囊充盈时输出道最大闭合压力74~142(98±23)cm H2O,空虚时为49~105(68±20)cm H2O,2者差异有统计学意义(t=8.82,P<0.01);充盈过程中无收缩波出现。结论改良回肠乳头瓣输出道及去管化回肠浆膜下隧道抗返流技术是比较理想的可控技术改进。
Objective To investigate the clinical effect of improved controllable ileum bladder. Methods Twelve cases of urinary diversion were treated by radical cystectomy in bladder cancer. The modified ileal papilla was used as the output tract. The external orifice and umbilical foramina were inserted into the anastomosis narrowing anastomosis. . Results 12 cases were followed up for 14 to 50 months. Satisfaction of diuresis was observed both day and night. Urine dynamics showed that the capacity of the storage diaphragms was 350-720 (435 ± 88) ml and the internal pressure was 15 32 (20 ± 5) cm H2O during filling The maximal closing pressure of the output channel was 74 ~ 142 (98 ± 23) cm H2O when emptying and 49 ~ 105 (68 ± 20) cm H2O when the alveolar filling was filled. The difference was statistically significant (t = 8.82, No contraction wave appeared during filling. Conclusion It is an ideal controllable technique to improve the anti-reflux of the ileal valve and the de-serosal subserosal tunnel anti-reflux technique.