论文部分内容阅读
目的 :探讨 3种可控性肠代膀胱术的手术方法 ,总结经验 ,逐步完善并推广该手术方法的应用。 方法 :13例患者中 ,10例施行去带可控盲升结肠膀胱术 (阑尾输出道 ) ,2例施行回肠可控膀胱术 (回肠输出道 ) ,1例施行回肠原位新膀胱术。 结果 :术后随访 2个月～ 2年 ,除 1例回肠新膀胱有尿失禁现象外 ,其余 12例均获得了良好的可控性。膀胱容量平均 30 0～ 4 0 0ml,白天 2～ 5h导尿 1次 ,夜间导尿 1～ 2次或夜间留置尿管 ,无插管困难。 1例去带可控盲升结肠膀胱术后 2个月时有一侧输尿管返流 ,1年后自愈。 结论 :(1)去除盲升结肠结肠带后 ,能有效地增加 3倍左右储尿囊容积 ,阑尾输出道可控性确切。 (2 )回肠可控膀胱 (回肠输出道 )亦取得了良好可控性 ,也是一种很好的可控膀胱方法之一。 (3)对合适病例施行回肠原位新膀胱术 ,是很理想的方法 ,符合生理排尿特点
OBJECTIVE: To explore the surgical methods of three controllable intestinal metaplastics, summarize the experience, and gradually improve and popularize the application of the surgical method. Methods: Of 13 patients, 10 patients underwent controlled blind ascending colon and bladder surgery (appendix output channel), 2 underwent ileal controllable bladder surgery (ileum output tract) and 1 underwent ileal neobladder surgery. Results: All cases were followed up for 2 months to 2 years. Except for 1 case of ileocecal urinary incontinence, the other 12 cases achieved good controllability. Bladder volume average 30 0 ~ 400ml, catheterization during the day 2 ~ 5h 1, catheterization at night 1 or 2 times or night catheter, no difficulty intubation. One case with controllable ascending colon and bladder surgery 2 months after ureteral reflux, after 1 year self-healing. Conclusions: (1) After removing the ascending colon colonic band, it can effectively increase the volume of the storage urine by about 3 times, and the controllability of the appendix output tract is exactly. (2) ileal controllable bladder (ileum output tract) has also achieved good controllability, but also a good one of the controllable bladder. (3) The appropriate cases of ileum in situ neobladder surgery, is a very good method, in line with the characteristics of physiological urination