膀胱癌原位新膀胱术后尿瘘影响因素分析

The influence factors of urine leakage after the operation of orthotopic neobladder for bladder cancer

目的观察膀胱癌原位新膀胱术后尿瘘发生的影响因素,为临床工作提供指导。方法收集膀胱癌原位新膀胱术后尿瘘患者22例,术后无尿瘘患者34例作对照。针对年龄、所选用的肠段、术后血浆白蛋白水平、术后新膀胱冲洗方式、发热、伤口局部感染等因素进行相关数据的收集与比较,并得出结论。结果尿瘘组与无尿瘘组在平均年龄、手术方式、术后血浆白蛋白水平等方面的差异无统计学意义(P>0.05);而两组间在术后新膀胱冲洗方式、术后发热及手术伤口局部感染等方面则差异明显(P<0.01或P<0.05)。结论年龄、所选用的肠段及术后血浆白蛋白水平对原位新膀胱术后尿瘘的发生无明显影响;而术后新膀胱冲洗方式、发热、手术伤口局部感染则与尿瘘的发生密切相关。术后持续膀胱冲洗、发热及手术伤口局部感染均可能导致新膀胱术后尿瘘的发生。

Objective To observe the influence factors of urine leakage after the operation of orthotopic neobladder for bladder cancer, and direct the clinical works. Methods 56 patients with orthotopic neobladder for bladder cancer were em- ployed, and 22 of them suffered urine leakage after the operation. The date of age, intestinal segments, plasma albumin after operation, the way of bladder washing, postoperative fever, and infection of wounds were collected and compared. Results There is no statistic difference at age, intestinal segments, plasma albumin after operation between urine leakage group and no urine leakage group（P〉0.05）. However, the difference of the way of bladder washing, postoperative fever, and infection of wounds between these 2 groups was statistically significant. Oonclusions Age, intestinal segments, plasma albumin after op- eration has no influence on urine leakage after the operation of orthotopic neobladder for bladder cancer, on the contrary, the way of bladder washing, postoperative fever, and infection of wounds are important factors of the urine leakage, sustained bladder washing, fever and infection of wounds after the operation can lead to urine leakage of the neobladder.