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目的:探讨原位U型回肠膀胱术后膀胱训练及康复指导方法。方法:12例肌层浸润性膀胱癌患者均行膀胱癌根治原位U型回肠膀胱术,术后给予规律、渐进、个体化膀胱训练和康复指导,随访观察患者储尿、控尿、排尿情况,并行尿流动力学检查。结果:术后随访3~36个月,控尿能力良好10例,单次排尿最大量450 mL,平均270 mL,残余尿量0~50 mL,平均30 mL。尿流动力学检查新膀胱容量270~410(310±70)mL,充盈期膀胱内压9~18(12±5)cm H2O,排尿期膀胱内压33~46(39±5)cm H2O,最大尿流率17~22 mL/s。结论:原位U型回肠膀胱术后膀胱训练和康复指导有助于患者储尿、控尿、排尿功能的建立。
Objective: To explore the method of urinary bladder training and rehabilitation in situ U-type ileum after bladder surgery. Methods: Twelve patients with invasive bladder cancer underwent radical urothelial bladder resection in situ. After operation, regular, progressive and individualized bladder training and rehabilitation guidance were performed. The urine storage, urine control and urination were observed , Parallel urodynamic examination. Results: The patients were followed up for 3 to 36 months. The controllable urinary incontinence was good in 10 cases. The maximal volume of single urination was 450 mL with an average of 270 mL. The residual urine volume was 0 ~ 50 mL with an average of 30 mL. Urinary flow tests showed a new bladder volume of 270 to 410 (310 ± 70) mL, a filling pressure of 9 to 18 (12 ± 5) cm H2O during filling, a bladder pressure of 33 to 46 (39 ± 5) cm H2O during voiding, Urine flow rate of 17 ~ 22 mL / s. CONCLUSION: The guidance of urinary bladder training and rehabilitation in situ U-shaped ileum after bladder surgery is helpful for the establishment of urine storage, urine control and urination in patients.