膀胱癌患者微创切除术后不同尿流改道方案的临床效果对比

发布时间：2018-02-17 06:34

  本文关键词： 尿流改道术 生活质量 膀胱切除术 微创　出处：《中国内镜杂志》2017年06期 　论文类型：期刊论文

【摘要】：目的 探讨膀胱癌患者微创切除术后不同尿流改道方案的临床效果。方法 选取2010年1月-2015年6月该院泌尿科收治的肌层浸润型膀胱癌患者127例,根据患者的病情接受不同的尿流改道方案,将患者分为原位回肠膀胱术组58例,Bricker膀胱术组33例,输尿管皮肤造口术组36例,比较3组患者一般资料、临床资料、术后并发症和生活质量评分。结果 3组患者的性别比例、年龄分布以及肿瘤分期的差异无统计学意义;手术时间和术后住院时间,原位回肠膀胱术组长于其他两组,Bricker膀胱术组长于输尿管皮肤造口术组,差异均具有统计学意义;术中出血量,原位回肠膀胱术组多于其他两组,Bricker膀胱术组多于输尿管皮肤造口术组,差异均具有统计学意义,两两比较肠功能恢复时间,原位回肠膀胱术组与Bricker膀胱术组差异无统计学意义,输尿管皮肤造口术组时间短于其他两组,差异具有统计学意义;3组患者近期并发症发生率的比较,差异无统计学意义;原位回肠膀胱术组的远期并发症总比例明显高于其他两组,差异具有统计学意义;原位回肠膀胱术组患者社会功能评分、总体健康评分高于其他两组,差异具有统计学意义。结论 原位回肠膀胱术无需外接装置,更接近生理排尿特征,术后生活质量较高,但是远期并发症发生率较高,输尿管皮肤造口术后恢复快,并发症较少,适应不宜长时间手术的患者。应根据患者个体状况选择合适的手术方式。
[Abstract]:Objective to investigate the clinical effect of different urinary diversion schemes in patients with bladder cancer after minimally invasive resection. Methods 127 patients with myometrial invasive bladder cancer treated in our department of urology from January 2010 to June 2015 were selected. According to different urinary diversion schemes, patients were divided into two groups: in situ ileal cystectomy group (n = 58), Bricker cystectomy group (n = 33) and ureteral dermatostomy group (n = 36). Results there were no significant differences in sex ratio, age distribution and tumor staging among the three groups. In situ ileal cystectomy and Bricker cystectomy in the other two groups in ureteral dermatostomy group, the difference was statistically significant. The in situ ileal cystectomy group was more than the other two groups, the difference was statistically significant. There was no significant difference between in situ ileal cystectomy group and Bricker cystectomy group. The time of ureterostomy group was shorter than that of the other two groups, the difference was statistically significant. The total proportion of long-term complications in the in situ ileal bladder operation group was significantly higher than that in the other two groups, the difference was statistically significant, the social function score and the overall health score of the patients in the in situ ileal bladder operation group were higher than those in the other two groups. Conclusion the in situ ileal bladder operation is more close to the physiological urination characteristics, and the quality of life is higher after operation, but the incidence of long-term complications is higher, and the recovery of ureteral dermatostomy is faster. The patients with less complications and unsuitable for long-term operation should choose the appropriate operation method according to the individual condition of the patients.
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