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目的 :探讨膀胱全切除术后患者理想的膀胱替代术式。方法 :采用 W形贮尿囊及球形贮尿囊代膀胱作低压可控性回肠代膀胱术治疗因膀胱癌而行膀胱全切除术患者 17例。结果 :随访 0 .5～ 2年 ,经代膀胱造影、测压和 IVU检查 ,效果满意 ,仅 5例术后出现不同的并发症 ,经对症处理均治愈 ;术后膀胱容量达 2 40～ 5 6 0 ml,膀胱静压为 2 .44～ 4.6 8k Pa。结论 :本术式代膀胱内压低、容量大、抗反流效果好 ,无明显输尿管梗阻及肾盂积水 ,无水电解质紊乱 ,是较理想的膀胱替代手术。
Objective: To investigate the ideal bladder replacement after total cystectomy. Methods: A total of 17 cases of bladder resection due to bladder cancer were treated with W-shaped storage keratoconjugate and bladder-shaped storage bladder for low-pressure controlled ileal replacement surgery. Results: All the patients were followed up for 0.5 to 2 years. The results of the cystography, manometry and IVU were satisfactory. Only 5 cases showed different complications after operation, and all the patients were cured after symptomatic treatment. The bladder capacity reached 240 ~ 5 60 ml, bladder static pressure of 2.44 ~ 4.6 8k Pa. CONCLUSION: This procedure has the advantages of low intra-bladder pressure, large capacity, good anti-reflux effect, no obvious ureteral obstruction and hydronephrosis and no electrolyte imbalance, which is an ideal bladder replacement surgery.