改良式乙状结肠直肠储尿囊术的临床效果评价.pdf

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1、178JModUrol，Vo1．2ONo．3Mar．2015·临床研究·改良式乙状结肠直肠储尿囊术的临床效果评价张长胜，孙天明，党乾元，苟成毅，张志鹏，曲小勇，高永峰(定西市人民医院泌尿外科，甘肃定西743000)ClinicalanalysisofimprovedsigmoidcolonrectumallantoicstoragetechniqueZHANGChang—sheng，SUNTian-ming，DANGQian-yuan，GOUCheng—yi，ZHANGZhi—peng，QUXiao—yong，GAOYong—feng(Departmen

2、tofUrology，People’SHospitalofDingxiCity，Dingxi743000，China)ABSTRACT：ObjectiveToevaluatethetherapeuticeffectsofmodifiedsigmoidcolonrectalstoreageallantoic．MethodsDuringFeb．1992toJun．2014，48casesofinvasivebladdercancerpatientsunderwentradicalcystectomy，onthebasisoforig—inalMainzbla

3、ddersurgeryIItypecontrolledurineflowoperation，whichmodifiedthesigmoidcolonrectumallantoicstoragetechnique．ResultsDuringthefollow—upof3monthsto5years，34patientshad2．5cmexpansionofunilateralrenalpelvis，theurinationwasstableandcontrollable．andthemaximumcapacitywas450～600mL．19patient

4、s’bloodCOzcpsuggestedpartialacid．Afteroralsodiumbicarbonate，therenalfunctionrecovered，andtheurinationwascontrollable．Besides，urineandstoolcouldbecompletelyseparated，withoccasionalincontinenceatnight．5casesdied，ofwhich1casediedofstrangula—tionobstructionandsepticshock1weekafterope

5、ration，1casediedofacutemyocardialinfarction1yearafteroperation，2casesdiedoftumormetastasis3yearsafteroperation，and1casediedofunknowncause．TumorrecurrenceandmetastasisOC-curredin6cases，2ofwhichhadpulmonarymetastasis，3hadpelviccavitymetastasis，1hadurethrametastasis．Ofallcases，1pati

6、entwasstillalive2Oyearsaftertheoperation．ConclusionsImprovedsigmoidcolonrectumallantoicstoragetechniqueissimpleandeffectiveinreducingurinestoolconfluence，retrogradeinfection，andmetabolicacidosis．Itproducesfewercom—plicationsandmaintainshighqualityoflife．Itiseasilyacceptedbybothdo

7、ctorsandpatients，andhaswideindications．KEYWORDS：bladderneoplasms；radicalcystectomy；sigmoidorectalpouch摘要：目的评价改良式乙状结肠直肠储尿囊术的临床效果。方法1992年2月至2014年6月，对48例肌层浸润性膀胱癌患者行根治性膀胱全切，在原Mainz膀胱Ⅱ式手术基础上进行可控尿流术式，即改良式乙状结肠直肠储尿囊术。结果术后随访3个月到5年结果显示：B超检查34例患者有单侧肾盂轻度扩张2．5cm，排尿稳定可控，最大容量为450~600mL；19例患者血CO

8、zcp提示偏酸，口服碳酸氢钠，肾功能均在正常范围，均可蹲位自行排尿，可控，尿粪均