去带可控盲升结肠膀胱术的尿动力学实验与临床研究

A study of detinia cecal ascending colon continent urinary reservoir

目的 评价去带可控盲升结肠膀胱术的应用价值。 方法 对１５ 头猪去带盲升结肠膀胱术动物实验模型及２３ 例膀胱癌患者去带可控盲升结肠膀胱术进行尿动力学测定，观察贮尿囊容量、内压及输出道压参数。 结果 动物实验结果显示切断结肠带后贮尿囊内压降低，容量、长度及周径均增加。２３ 例患者术后均获得了良好的可控，３ 个月贮尿囊容量可达４００ｍｌ。１３ 例术后（１９．２±８．９）个月尿动力学显示贮尿囊最大容量为（６９７ ±２０４）ｍｌ，最大充盈压为（５８ ．７ ±２４．５）ｃｍＨ２Ｏ，输出道最大闭合压为（１０４ ．３±３３ ．８）ｃｍＨ２Ｏ。 结论 该术式可以获得大容量、低内压的贮尿囊，具有操作简单、可控效果好、节省肠袢等优点。

Objective To evaluate the detinia cecal ascending colon continent urinary reservoir. Methods Urodynamic examinations were made in 15 pigs with detinia cecal ascending colon urinary reservoir and in 23 cases of bladder carcinoma with detinia ascending colon urinary reservoir after total cystectomy.The reservoir capacity,intrareservoir pressure and the efferent pressure were surveyed. Results In all the 15 experimental pigs,the reservoir capacity,the length and perimeter were increased after teniamyotomy.The clinical results of the 23 patients showed that the reservoir achieved a capacity of 400ml 3 months after operation.Urodynamic data of 13 patients showed a maximum reservoir capacity of 697±204ml, a mean full filling pressure of 58.7±24.5 cmH 2O, and a mean maximum urethral (efferent) closure pressure of 104.3±33.8cmH 2O at 19.2±8.9months.Reliable continence has been achieved in all the 23 patients. Conclusions This procedure achieve an adequate capacity and a low intrareservoir pressure.The advantages are technically simpler and easier with reliable continence and shorter length of intstinal segment required to construct the reservoir.