回结肠正位膀胱术后下尿路尿动力学研究

Urodynamic study of lower urinary tract undergone ileocolonic orthotopic bladder substitution

目的 评估回结肠正位膀胱术后的下尿路储尿囊及流出道尿动力学状况。方法 对 11例回结肠正位膀胱术患者术后进行储尿囊及流出道的充盈性测压和静态压力图测定 ,检测储尿囊的压力、顺应性 ,以及流出道的压力和阻力状态。结果 11例患者储尿囊容量、储尿压、排尿压分别为 :(5 18.5± 184 .3)ml,(2 6 .7± 6 .6 )cmH2 O ,(36 .2± 14 .9)cmH2 O ,储尿囊的顺应性为先高顺应后低顺应。膀胱颈压为 (78.6± 17.9)cmH2 O ,最大尿道压为 (10 8.4± 32 .7)cmH2 O。流出道压力中吻合口压力偏高。结论 回结肠正位膀胱术储尿囊可正常储尿 ,术后排尿困难与储尿囊的低压及吻合口的高压状态有关。

Objective To evaluate the urodynamic status of lower urinary tract undergone ileocolonic orthotopic bladder substitution.Methods Eleven cases with ileocolonic orthotopic bladder substitution were detected with the cystometry and the rest urethral pressure profile.The pressure and the compliance of the sack,and the resistance of the outlet as well,were detected.Results The capacity of the sack was 518.5±184.3ml,and the pressure of storage and voiding were respectively (26.7±6.6)cm H 2O,( 36.2 ±14.9)cm H 2O.The sack had high compliance,following with low compliance.The pressure of the bladder neck was (78.6± 17.9 )cm H 2O,and the maximum pressure of the urethral was (108.4±32.7)cm H 2O.Conclusion The sack of the ileocolonic orthotopic bladder can store normally,and the dysuria relates to the low pressure of the sack and the high resistance of the anastomose.