论文部分内容阅读
目的:评价阑尾或肠管可控输出道在高反射性神经源性膀胱治疗中的应用价值。方法:采用阑尾输出道(Mitrofanoff法)治疗高反射性神经源性膀胱患者4例,采用回肠腹壁造口(Yang-Monti法)治疗2例。3例采用膀胱自扩大,同时行阑尾输出道2例,回肠腹壁造口1例;3例行回肠膀胱扩大,同时采用阑尾腹壁造口2例,回肠腹壁造口1例。结果:术后随访3～39个月(平均20个月)。1例采用回肠扩大阑尾VZQ造口的患者术后2周造口部皮瓣感染坏死,改行阑尾直接造口;1例阑尾输出道出现造口部位漏尿,缩短导尿间隔为2 h,漏尿消失;其他患者控尿良好。5例术后肾功能恢复正常,1例保持稳定。结论:阑尾或回肠可控输出道在高反射性神经源性膀胱治疗中是一种安全可靠的方法。
OBJECTIVE: To evaluate the value of controllable output ducts of appendix or intestine in the treatment of highly reflexive neurogenic bladder. Methods: Four cases of high reflex neurogenic bladder were treated with the Mitrofanoff method. Two cases were treated by Yang-Monti method. 3 cases of bladder self-expanding, while the line of appendix 2 cases of appendix, ileal abdominal wall stoma in 1 case; 3 cases of ileal bladder enlargement, while using appendix abdominal wall in 2 cases, ileal abdominal wall in 1 case. Results: The patients were followed up for 3 to 39 months (average 20 months). One case with ileum to expand the appendix VZQ stoma patients were infected with necrosis of the ostomy flap 2 weeks after the operation and the appendix was diverted directly to the stoma. One case of the appendix had leakage of stoma at the stoma, shortened the catheterization interval of 2 h, Disappeared; other patients with good urine control. Renal function returned to normal in 5 cases and remained stable in 1 case. CONCLUSIONS: The appendix or ileal controllable output tract is a safe and reliable method for the treatment of highly reflexive neurogenic bladder.