摘要
目的探讨回肠膀胱扩大术治疗结核性挛缩膀胱的诊治经验及疗效。方法回顾性分析2016年9月至2017年8月合肥医科大学附属医院7例晚期泌尿系结核患者的临床资料。所有患者经抗结核治疗2~4周后行患肾切除术,并在抗结核治疗2~6个月后行保留原膀胱的回肠膀胱扩大术。结果所有患者术后平均住院13.6d,均能自行排尿,术后2周最大膀胱容量扩大至120~209mL,平均180mL。术后1个月膀胱最大容量扩大至310~375mL,平均354mL。健侧肾积水、肾功能损伤以及膀胱残余尿情况在术后有加重趋势,尤其在术后3个月最严重,但术后6个月上述情况均较术后3个月时明显好转(P<0.05),而与术前比较差异无统计学意义(P>0.05)。术后1个月生活质量评分(SF-36)与术前比较差异无统计学意义(P>0.05),而术后3个月及术后6个月生活质量较术前改善,差异具有统计学意义(P<0.05)。所有患者尿频、尿急、尿失禁症状均有明显改善,肾功能未出现进一步恶化。结论保留原膀胱的回肠膀胱扩大术是治疗晚期肾结核挛缩膀胱的有效方法。
Objective To explore the surgical procedures and efficacy of bladder-preserving ileum augmentation cystoplasty in treating tuberculous contracted bladder.Methods The clinical data of 7 patients with advanced urinary tuberculosis(UTB)who were admitted into the Affiliated Hospital of Zunyi Medical University during Sep.2016 and Aug.2017 were retrospectively analyzed.All patients received 2-4 weeks antituberculosis therapy before the affected kidney was removed.After2-6 months,bladder-preserving ileum augmentation cystoplasty was performed.Results The mean postoperative hospitalization was 13.6 d.All patients regained auto-urination after surgery.The maximal bladder volume reached 120-209 mL(mean180 mL)2 weeks after surgery,and reached310-375 mL(mean354 mL)after one month.Hydronephrosis,renal impairment,and residual urine tended to aggravate in the contralateral kidney after surgery,especially 3 months after surgery.However,these conditions improved significantly 6 months after surgery as compared with 3 months after surgery(P<0.05),but there was no significant difference between the preoperative level and the postoperative level after 6 months(P>0.05).There was no significant difference in quality of life score(SF-36)between the postoperative and the preoperative after one month(P>0.05),but the quality of life improved at 3 or 6 months after operation.The difference was statistically significant(P<0.05),and the quality of life improved significantly.The symptoms of frequency of urination,urgency of urination and urinary incontinence were significantly improved in all patients,and the renal function was not further deteriorated.Conclusion Bladderpreserving ileum augmentation cystoplasty is an effective treatment for tuberculous contracted bladder.
作者
李泰
郭亚南
彭显月
乐俊钧
李成
宋先初
梁天才
梁国标
LI Tai;GUO Ya-nan;PENG Xian-yue;LE Jun-jun;LI Cheng;SONG Xian-chu;LIANG Tian-cai;LIANG Guo-biao(Department of Urology,Affiliated Hospital of Zunyi Medical University,Zunyi 563000;Department of Urology,First People s Hospital of Zunyi,Zunyi 563000,China)
出处
《现代泌尿外科杂志》
CAS
2020年第4期302-305,共4页
Journal of Modern Urology
基金
贵州省科学技术基金(No.黔科合J字[2014]2187号)
合肥医学院博士启动基金(No.ZMKD[2012]017)。
关键词
回肠膀胱扩大术
肾结核
结核性挛缩膀胱
诊断
治疗
ileum augmentation cystoplasty
renal tuberculosis
tuberculous contracted bladder
diagnosis
treatment
