目的从膀胱肿瘤术后患者生活质量角度,评估采取原位回肠尿流改道术、原位乙状结肠尿流改道术、输尿管皮肤造瘘、可控腹壁尿流改道术的疗效,为膀胱肿瘤治疗方法的评价提供依据。方法采用简明健康状况调查问卷(MOS 36-item Short Form Health Survey,SF-36)对昆明医科大学第二附属医院2008—2010年实施膀胱全切尿流改道术的81例患者进行调查,比较术后6个月、1年和2年患者的生活质量。结果原位尿流改道术组在社会功能(SF)、情感角色(RE)、心理健康(MH)评分上明显高于非原位尿流改道术组(P<0.05)。原位回肠和原位乙状结肠尿流改道术组间,输尿管皮肤造瘘组和可控腹壁尿流改道组间差异不具有统计学意义(P>0.05)。结论原位尿流改道术后患者能够获得比非原位尿流改道术更好的生活质量。 Objective To evaluate the efficacy of orthotopic ileal urinary diversion, orthotopic sigmoid urinary diversion, ureteral skin ostomy and controllable abdominal wall urinary diversion from the perspective of quality of life of patients with bladder cancer. Evaluation provides the basis. Methods Eighty-one patients undergoing total cystectomy urinary diversion from 2008 to 2010 in the Second Affiliated Hospital of Kunming Medical University were surveyed by the MOS 36-item Short Form Health Survey (SF-36) Quality of life of patients after 6 months, 1 year and 2 years. Results In situ urinary diversion group was significantly higher than non-native urinary diversion group in social function (SF), emotional role (RE) and mental health (MH) scores. There were no significant differences between the ileal and in situ sigmoid urinary diversion groups, the ureteric ostomy group and the controllable abdominal wall urinary diversion group (P> 0.05). Conclusion Patients with orthotopic urinary diversion can achieve better quality of life than non-orthotopic urinary diversion.