摘要
目的 探讨体外可控性回肠代膀胱术的可行性及效果。方法 距回盲部 20 cm处取35 cm回肠,中段折叠成 N形并将其对系膜缘纵形剪开,缝制成贮尿囊;近端回肠作为输入道,远端回肠作为尿流输出道,将此段回肠于下腹壁造瘘口处穿出体外,于造瘘口处取双片梯形皮瓣包绕外露肠管缝制成皮管,制成输出道。将尿液控制器置于皮管外,利用气囊控制排尿。结果 10例动物顺利度过手术期。术后6个月内肝肾功能、电解质、血糖及血脂均与术前差异无显著性(P>0.05)。尿动力学检查:术后 3个月时平均贮尿囊最大容量为(150±40)ml,最大充盈压为(24.4±5.3)cm H_2O(1 cm H_2O=0.098 kPa),贮尿囊顺应性好。X线影像学检查:肾脏显影良好,输尿管通畅,贮尿囊充盈良好,无输尿管逆流。尿液控制器的排尿效应:气囊充气后,无尿液流出;气囊消气后,尿液呈粗线条流出。结论 该尿流改道术式可达到体外控制排尿的效果,手术操作比较简单、并发症少。
Objective To evaluate the feasibility and effect of the urinary diversion by ileal reser-
voir with self controllable urination. Methods A segment of 35 cm ileum was taken, from which, the
middle portion was made into N shaped reservoir and the proximal 8 cm portion was used as afferent
limb. The distal portion was pulled out at the stomal site where the two skin flaps were taken and encir-
cled the efferent ileum to constitute the urinary outflow. A urinary controller similar to penile clamp was
applied to control the urination with a balloon. Results 10 of 12 dogs survived from the operation and
were followed up for 6 months. On the third month, urodynamic examination showed the reservoir
reached a maximum capacity of (150±40) ml, a full filling pressure of (24. 4±5. 3) cmH_2O. X ray ex-
amination showed good excretory function of the kidney, without hydronephrosis. All dogs could control
the urination through the urinary controller. Conclusion The new procedure has advantages of self con-
trol of urination, simple surgical performance and few complications.
出处
《中华实验外科杂志》
CAS
CSCD
北大核心
2003年第8期738-739,共2页
Chinese Journal of Experimental Surgery
