直肠癌根治术后并发膀胱功能障碍患者尿流动力学特点的分析

Analysis of the characteristics of urodynamics in patients with bladder dysfunction after radical resection of rectal cancer

目的:探讨并分析接受直肠癌根治术后并发膀胱功能障碍患者的尿流动力学特点。方法:选择近年来在南京医科大学附属无锡人民医院接受直肠癌根治术后并发膀胱功能障碍的133例患者作为研究对象。对这些患者均进行尿流动力学检查,观察并记录其尿流动力学特点。结果:对这133例患者进行尿流动力学检查的结果显示,其中逼尿肌收缩力低下的患者有100例(占75.2%),经治疗有93例患者在术后3个月内恢复正常排尿,有7例患者在术后3个月仍未恢复正常排尿,需长期留置导尿管或膀胱造痿管;其中逼尿肌不稳定收缩的患者有27例(占20.3%),尿道括约肌功能不全的患者有6例(占4.5%),经对症治疗这33例患者的症状均显著改善。结论:接受直肠癌根治术后并发膀胱功能障碍患者的尿流动力学特点主要是逼尿肌收缩力低下、逼尿肌不稳定收缩和尿道括约肌功能不全,经对症治疗其预后良好。

Objective:To investigate and analyze the characteristics of urodynamics in patients with bladder dysfunction after radical resection of rectal cancer.Methods:A total of 133 patients with bladder dysfunction who underwent radical resection of rectal cancer in Wuxi People's Hospital of Nanjing Medical University in recent years were selected as subjects.All the patients were examined by urodynamics,and the characteristics of urodynamics were observed and recorded.Results:of the 133 patients of urine flow mechanics test,according to the results of the patients with low detrusor contraction force of 100 cases(75.2%),with 93 cases patients treated by 3 months after surgery to restore normal urination,seven patients in postoperative 3 months still not back to normal urination,need long-term indwelling catheter or bladder fistula;There were 27 cases of detractor instability(20.3%) and 6 cases of urethral sphincter insufficiency(4.5%).The symptoms of all 33 patients were significantly improved after symptomatic treatment.Conclusion:The urodynamic characteristics of patients with bladder dysfunction after radical resection of rectal cancer are mainly low contractility of detrusor,unstable contractility of detrusor and insufficiency of urethral sphincter,and the prognosis is good after symptomatic treatment.