摘要
目的:比较膀胱自扩大术和回肠膀胱扩大术治疗神经源性膀胱的临床效果。方法:回顾分析膀胱自扩大术10例,回肠膀胱扩大术13例患者临床资料,对两种术式的手术方法,手术前后患者膀胱容量,肾功能以及临床症状进行比较。结果:膀胱自扩大术和回肠膀胱扩大术的患者术后平均安全膀胱容量显著增多,分别为(178.2±31.8)vs(420.7±54.9)ml,(115.9±19.5)vs(517.4±48.3)ml(P<0.05),顺应性明显改善。前者尿失禁消失8例,明显改善1例;术后血清肌酐水平恢复正常6例,明显下降2例,肾积水明显缓解或消失,未发现膀胱输尿管反流现象;后者尿失禁消失9例,明显改善2例,血清肌酐水平6例恢复正常,1例明显下降,肾积水情况均较术前明显缓解或消失,膀胱输尿管反流消失;术后3例出现尿路感染;1例轻微漏尿;1例出现腹泻;3例出现肠梗阻;2例出现膀胱结石,均对症处理后好转。结论:膀胱自扩大术较为简单、安全,但其适应证把握应慎重。回肠膀胱扩大术是治疗神经源性膀胱有效的手术方式,其适应证相对广,但并发症较多。
Objective：To compare the preliminary clinical results of two different bladder enlargement procedures for the treatment of neurogenic bladder. Method：To analyze ten patiens underwent auto-augmentation and thirteen patiens underwent ileocystoplasty retrospectively.Compare the surgical techniques,pre-and post-operative bladder capacity and renal functions of the two kinds of operation. Result：After operation,the safe bladder capacity increased respectively（178.2±31.8） vs（420.7±54.9）ml,（115.9±19.5） vs（517.4±48.3）ml（P0.05）,the bladder compliance significantly increased.Among the patients with auto-augmentation,incontinence disappeared in 8,and improved markedly in 1.The renal function became normal in 6 and improved significantly in 2.The hydronephrosis improved and the vesicoureteral reflux disappeared.Among the patients with ileocystoplasty,incontinence disappeared in 9,and improved markedly in 2.The renal function became normal in 6 and improved in 1.The hydronephrosis improved and the vesicoureteral reflux disappeared.In ileocystoplasty group,three patients had episodes of UTI,one patient experienced urine leakage,one patient had diarrhea,three patients had intestinal obstruction,one patient had vesical calculus.All the complications improved after treatment. Conclusion：Bladder auto-augmentation is simple and safe,but it should be choosed circumspectly;Ileocystoplasty has significant curative effect,but it has more complications.
出处
《临床泌尿外科杂志》
2012年第2期121-123,共3页
Journal of Clinical Urology
