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1、胃、回肠、乙状结肠代膀胱术临床效果的比较研究陈志朋1*罗照2王德林2(1第三军医大学西南医院泌尿外科,重庆 400038;2重庆医科大学附属第一医院泌尿外科,重庆400016;*通讯作者)摘要:目的评价胃,回肠,乙状结肠代膀胱手术治疗效果及短期并发症分析。方法回顾性分析我院2005-2010年60例膀胱癌根治原位新膀胱患者临床资料。其中14例行胃代膀胱术(胃组),27例行回肠代膀胱术(回肠组),19例行乙状结肠代膀胱术(乙状结肠组),比较三组患者手术时间,术中出血,术后住院天数,术后胃肠功能恢复时间,以及短期并发症
2、发生率。结果其中手术时间,胃组﹥回肠组﹥乙状结肠组(P﹤0.05);术中出血,胃组明显多于回肠组和乙状结肠组(P﹤0.05),而回肠组和乙状结肠组差异无统计学意义(P﹥0.05);术后住院天数,回肠组多于胃组和乙状结肠组(P﹤0.05),乙状结肠组和胃组差异无统计学意义(P﹥0.05);术后胃肠功能恢复时间,回肠组少于胃组和乙状结肠组(P﹤0.05),乙状结肠组和胃组差异无统计学意义(P﹥0.05);术后并发症的发生率回肠组﹥乙状结肠组﹥胃组。结论胃代膀胱术较回肠和乙状结肠代膀胱术,手术时间长,术中出血较多,但术后
3、并发症少;乙状结肠组相较回肠组,手术时间短,术后住院恢复时间和并发症发生率相对较低。关键词:浸润性膀胱癌;尿流改道;原位代膀胱Comparativestudyoftheclinicaleffectofbladderreconstructionsurgerywithstomach,ileum,orsigmoid,andtheanalysisofshorttermcomplications.ChenZhipeng1,LuoZhao2,WangDelin2.(1InstituteofUrologyofPLA,Southw
4、esternHospital,3rdMilitaryMedicalUniversity,Chongqing400038;2DepartmentofUrology,FirstAffiliatedHospitalofChongqingMedicalUniversity,Chongqing400016).ABSTRACT:ObjectiveEvaluationoftheeffectofbladderreconstructionsurgerywithstomach,ileum,orsigmoid,andoftheanaly
5、sisofshorttermcomplications.MethodsWeretrospectivelyreviewedtheclinicaldataofthe60patientswhoacceptedradicalbladdercystectomyandurethrareconstructionfrom2005to2010inourhospital,amongwhom14patientswerereconstructedurethrawithstomach(stomachgroup),27patientswith
6、Ileum(ileumgroup),and19patientswithsigmoid(sigmoidgroup).Threegroupswerecomparedinoperativetime,intraoperativebloodloss,postoperativehospitalday,timeforpostoperativegastrointestinalfunctionrecovery,aswellasshort-termcomplicationrate.Resultsoperativetime:stomac
7、hgroupismost,ileumgroupismorethansigmoid(P﹤0.05).Bloodloss:thestomachwasobviousmorethantheileumgroupandsigmoidgroup(P﹤0.05),buttherewasnodifferencebetweenileumandsigmoidinstatistics.postoperativehospitalday:theileumwasobviousmorethanstomachandsigmoid(P﹤0.05),b
8、uttherewasnodifferencebetweenstomachandsigmoidinstatistics.Thetimeforgastrointestinalfunctionrecoveryinileumgroupwaslessthanstomachandsigmoid(P﹤0.05),buttherewasnodifferencebetween