回肠纵行折叠抗返流方法的实验研究和临床应用

Exprimental study and clinical application of longitudinal ileum folding antireflux technique

以狗在体回肠制作了不同长度回肠纵行折叠和回肠套叠５ｃｍ乳头瓣抗返流措施的动物模型，用顺流压、返流压综合评价抗返流效果。结果回肠纵行折叠６ｃｍ的顺流压为２．３８±１．３３ｋＰａ，返流压为４．０５±２．１２ｋＰａ，是尿流改道术中最佳抗返流长度；回肠套叠５ｃｍ乳头瓣的顺流压为３．９２±１．００ｋＰａ，返流压大于９．１８ｋＰａ，其抗逆流作用强但顺流压较高。随访临床应用回肠纵行折叠抗返流的４０例患者，术后血ＢＵＶ，Ｃｒ和血电解质均在正常范围，ＩＶＵ除一例双肾积水外，尿液流入膀胱通畅，膀胱造影无返流。

Longitudinal ileun folding and intussuscepted ileal nipple antireflux technique were performed on dogs.Antireflux effect was evaluated with antegrade and retrograde pressure, The antegrade pressure of longitudinally folded 6cm ileum was 2.38±1.33kpa and the retrograde pressure 4. 05±2. 12kPa and 6cm length was considered the best. The antegrade pressure of intussuscepted 5cm ileal nipple was 3.92±1. 00kPa and the retrograde pressure higher than 9. 81kpa.Longitudinal ileum folding antireflux method has been carried out in 40 patients and IVPs showed no obstruction except bilateral hydronephrosis in one.Cystogram performed in 20 patients showed no reflux.