改良Studer回肠新膀胱术后早期尿动力学动态变化特征

发布时间：2018-03-20 13:18

本文选题：尿动力学　切入点：膀胱癌　出处：《现代泌尿外科杂志》2017年05期 　论文类型：期刊论文

【摘要】：目的回顾性分析行根治性膀胱全切术+改良Studer回肠新膀胱术后早期连续尿动力学变化特征。方法选取因患膀胱癌而行根治性膀胱全切术+改良Studer回肠新膀胱术术后早期(术后1年以内)规律行尿动力学检查的患者49例,对比分析其尿动力数据。结果共有49例患者(男33例,女16例)至少在术后早期规律完成两次尿动力学检查,其中21人规律完成3次尿动力学检查。术后第3月、6月及12月尿动力学检查中最大膀胱容量(274.0±88.3 vs.296.7±91.3 vs.350.5±98.0)mL、充盈期最大膀胱压(31.1±13.9 vs.27.8±20.2 vs.19.6±12.8)cmH2O、充盈期新膀胱出现收缩时新膀胱容量(139.0±71.0 vs.150.5±85.5 vs.210.1±76.9)mL,其中术后第6月及12月尿动力学参数比较有统计学差异(P0.05);然而最大尿流率(9.1±5.1 vs.8.5±4.8 vs.8.6±5.5)mL/s、残余尿量(22.5±53.8 vs.36.1±80.0 vs.21.0±46.2)mL、最大尿道关闭压(59.8±26.2 vs.69.6±42.2 vs.71.7±46.7)cmH_2O、功能尿道长度(31.5±8.5 vs.32.1±9.9 vs.30.5±9.8)mm无统计学差异(P0.05)。在术后12月,男性最大尿道关闭压(88.6±54.5)cmH_2O、功能尿道长度(34.6±9.5)mm分别与女性最大尿道关闭压(49.1±22.3)cmH_2O、功能尿道长度(24.0±6.4)mm相比较有显著性统计学差异(P0.05)。结论改良Studer回肠新膀胱术是一种理想的尿流改道方式,具有适当容量、低内压、良好顺应性特点,且随着时间的推移新膀胱的功能不断完善。
[Abstract]:Objective To retrospectively analyze the radical cystectomy + modified Studer neobladder after early continuous urodynamic changes. Methods with bladder cancer underwent radical cystectomy and modified Studer neobladder postoperative early (1 years after operation) 49 patients underwent urodynamic examination of the law and the comparative analysis of the urodynamic data. Results a total of 49 patients (male 33 cases, female 16 cases) at least in the early postoperative period of two urodynamic examination, 21 of them completed 3 of urodynamic examination. Third months after the operation, in June and December of urodynamic examination in maximum bladder capacity (274 + 88.3 vs.296.7 + 91.3 vs.350.5 + 98 mL), maximum bladder pressure during filling (31.1 + 13.9 vs.27.8 + 20.2 vs.19.6 + 12.8 cmH2O), the new bladder filling period of contraction of new bladder capacity (139 + 71 vs.150.5 + 85.5 vs.210.1 + 76.9) mL, which after sixth December January and urodynamic parameters were statistically significant difference (P0.05); however, the maximum urine flow rate (9.1 + 5.1 vs.8.5 + 4.8 vs.8.6 + 5.5 mL/s), residual urine volume (22.5 + 53.8 vs.36.1 + 80 vs.21.0 + 46.2 mL), maximum urethral closure pressure (59.8 + 26.2 vs.69.6 + 42.2 vs.71.7 + 46.7 cmH_2O). Functional urethral length (31.5 + 8.5 vs.32.1 + 9.9 vs.30.5 + 9.8 mm) had no statistical difference (P0.05) in December. After the operation, the male maximum urethral closure pressure (88.6 + 54.5) cmH_2O, functional urethral length (34.6 + 9.5) mm respectively and female maximum urethral closure pressure (49.1 + 22.3) cmH_2O, the function of urethra the length of (24 + 6.4) mm compared with significant statistical differences (P0.05). Conclusion the modified Studer neobladder is an ideal way of urinary diversion, with appropriate capacity, low pressure, good compliance characteristics, and with the push to move new bladder function time of continuous improvement.

【作者单位】：第三军医大学西南医院全军泌尿外科研究所;
【分类号】：R699.5

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