乙状结肠新膀胱术治疗膀胱肿瘤23例疗效观察

The Value of the Sigmoid Cystoplasty in 23 cases of Cystocarcinoma

目的 :观察膀胱全切术后乙状结肠新膀胱术治疗膀胱肿瘤的效果 .方法 :采用U型贮尿囊代膀胱作可控性乙状结肠新膀胱术治疗 2 3例男性膀胱癌而行膀胱全切术患者 .结果 :术后 18例获得随访 ,术后随访 0 5～ 8a ,经IVP ,CT ,肾功及电解质等检查 ,疗效满意 .手术时间平均 2 60min ,输血平均 5 2 0mL . 2例出现尿道狭窄 ,行尿道扩张治愈 ;2例出现单侧肾积水 ;2例术后 1a出现轻度高氯血症 ;1例半年死于肿瘤复发 ;3例死于非原发疾病 .术后膀胱容量达 2 80～ 5 0 0mL ,膀胱静压为 18 5～ 3 6 4cmH2 O .结论 :本术式具有贮尿囊容积大 ,内压低 ,顺应性好 ,尿液可控 ,抗反流效果好 ,输尿管梗阻及肾盂积水少 ,无明显的水电解质及酸碱平衡紊乱 ,原位自主排尿等优点 。

To investigate the value of the sigmoid cystoplasty after cystectomy in patients with cystocarcinoma. Methods: U-shaped urodochia were used in the controllable sigmoid cystoplasty after cystectomy in 23 males with cystocarcinoma. Results: 18 cases were followed up after cystoplasty for 1～8?years. The results of IVP, CT, renal function test and electrolyte detection were pleasant. The time of operation and blood infusion were 260 minutes and 520?mL respectively on the average. The volume of the urodochium was 280～500?mL, and its staticpressure was 18.5～36.4?cmH 2O. Conclusion: The sigmoid cystoplasty has several advantages and is a better operation in replacing the urocyst.