三种膀胱造瘘术临床效果比较

To observe the clinical effect of throe types of Cystostomy

目的观察三种膀胱造瘘术的临床疗效。方法回顾性分析我院1989年12月-2008年12月收治的655例行膀胱造瘘术患者资料，根据术式的不同分为三组：第一组：传统膀胱穿刺造瘘术；第二组：蕈状导尿管横穿腹直肌造瘘改良术；第三组：耻骨上穿刺膀胱造瘘术。分析比较三组手术时间、住院时间和瘘口愈合的情况。结果第二组手术时间、住院时间和瘘口愈合时间明显少于其他两组（P〈0．05）。认为蕈状导尿管横穿腹直肌造瘘改良术创伤小、适应证更广，基本无并发症。传统造瘘术后拔管尿外溢2～8d，耻骨上穿刺膀胱造瘘术拔管后尿外溢1～5天，而蕈状导尿管横穿腹直肌造瘘改良术拔管尿外溢1～2d，明显缩短住院日及减少换药次数。结论蕈状导尿管横穿腹直肌造瘘改良术较之传统的造瘘术具有明显优势。耻骨上穿刺膀胱造瘘术应用更广泛。

Obatract Observe the clinical effect of three types of cystostomy.Methods Retrospective analysis of our hospital during December 1989-2008,655 cases of cystostomy were taken.Patients were divided into three groups.First group：using traditional cystostomy.Second group： with improved ostomy surgery; mushroom guide catheter across the rectus abdominis. Third group： with suprapubic bladder puncture.Compared these three groups with the time for operation, hospitalization and the situation of fistula healing.Results The time for operation,hospitalization and fistula healing of the second group were shorter than the other groups（P〈 0.05）.h is considered that the improved ostomy surgery that mushroom guide catheter across the rectus abdominis has some good points of tiny wound, no complications, wide indication.h appeared that urine flow over during 2 to 8 days after extubating using the traditional cystostomy, but it happened during 1 to 2 days using the important ones.And it happened in the third group during 1 to 5 days.Obviously the time for the hospitalization and the times of change of dressing.Conclusions There were an obvious advantage between the improved ostomy surgery and the conventional possess.Suprapubic bladder puncture fistulization has wider application.