胡玉强　王娟　王少锋

[摘要] 目的 观察全膀胱切除直肠代膀胱与回肠膀胱术的疗效。方法 方便选取该院130例进行全膀胱切除直肠代膀胱手术的患者，116例进行回肠膀胱手术的患者病例均选自2013年6月—2016年6月期间，根据不同的尿道改流方式分为全膀胱切除直肠代膀胱组以及回肠膀胱组。进行回顾性分析，观察患者并发症、手术时间、手术出血量、住院时间、手术后排尿次数等情况。结果 选取的患者均進行全膀胱切除术，手术均成功。在住院期间，进行直肠代膀胱手术的患者有14例发生并发症，进行回肠膀胱手术的患者有19例发生并发症。回肠膀胱术尿道改道的方法在手术时间（5.3±1.3）h，手术出血量（195.74±15.26）mL，住院时间（26.5±5.4）d，手术后排尿次数（5.5±1.7），并发症的发生（16.38%）中与直肠代膀胱（3.5±1.2）h，（153.54±14.26）mL，（21.5±5.3）d，（9.4±1.5），（10.76%）相比均差异有统计学意义（P<0.05）。 结论 对于发生浸润性的膀胱肿瘤的患者实行全膀胱切除手术效果良好，尿道改流中直肠代膀胱优于回肠膀胱术。

[关键词] 全膀胱切除；直肠代膀胱；回肠膀胱术

[中图分类号] R737 [文献标识码] A [文章编号] 1674-0742（2017）07（c）-0024-03

[Abstract] Objective To observe the curative effect of rectum for bladder replacement following total cystectomy and ileal cystoplasty. Methods Convenient selection 130 cases of patients with rectum for bladder replacement following total cystectomy from June 2013 to June 2016 were selected and 116 cases were treated with ileal bladder surgery， and divided into the rectum for bladder replacement following total cystectomy group and ileal cystoplasty group according to different urethral diversion methods， and the complications， operative time， intraoperative bleeding amount， length of stay and postoperative micturition frequency of patients were reviewed. Results All the patients selected were treated with radical cystectomy， successfully， during the hospitalization period， there were 14 cases with complications in the patients with rectum for bladder replacement following total cystectomy group and 19 cases with complications in the patients with ileal cystoplasty， and the differences in the operation time， intraoperative bleeding amount， length of stay， postoperative micturition frequency and occurrence of complications between the ileal cystoplasty surgery and the rectum for bladder replacement surgery were obvious with statistical significance[（5.3±1.3）h， （195.74±15.26）mL， （26.5±5.4）d， （5.5±1.7）， 16.38% vs （3.5±1.2）h，（153.54±14.26）mL，（21.5±5.3）d，（9.4±1.5），（10.76%）]（P<0.05）. Conclusion The effect of radical cystectomy of patients with invasive bladder tumor is good， and the effect of rectal neobladder in the urethral diversion is better than that of ileal cystoplasty.

[Key words] Radical cystectomy； Rectal neobladder； Ileal cystoplasty

膀胱肿瘤是一种常见的泌尿系统的肿瘤，在临床上患者出现间歇性，无痛性以及全程肉眼血尿的症状[1]。在治疗中使用全膀胱切除术，可以降低患者的死亡率差。直肠代膀胱和回肠膀胱术均为进行全膀胱切除手术后的尿流改道[2]。该文中选取该院130例进行全膀胱切除直肠代膀胱手术的患者，116例进行回肠膀胱手术的患者，病例均方便选自2013年6月—2016年6月期间。进行回顾性分析，发现患者治疗的效果的情况，现报道如下。

1 资料与方法

1.1 一般资料endprint

方便选取该院130例进行全膀胱切除直肠代膀胱手术的患者，116例进行回肠膀胱手术的患者，进行回顾性分析，观察患者治疗效果。……