【摘要】 目的 探讨改良Indiana尿囊和Penn尿囊术的疗效 ,以改善全膀胱切除术病人的生活质量。方法25例膀胱切除病人分别施行了改良Indiana尿囊(14例)和Penn尿囊术(11例 ) ,并对尿囊容量、压力、可控性以及并发症进行观察。平均随访时间22.5个月。 结果 改良Indiana尿囊和Penn尿囊的平均最大容量在术后3个月时分别为 (461.18±67.89)ml和 (482.73±3±59.79)ml,囊内压分别为 (1.80±0.46)kPa和(1.87±0.52)KPa ,在术后1年时其容量分别增至(626.83±61.56)ml和(593.27±71.35)ml,而囊内压则分别降至(1.37±0.46)kPa和(1.23±0.32)kPa。16例用阑尾作为输出道者尿控良好 ,而9例用回肠作输出道者有3例出现部分失禁。无输尿管吻合口狭窄和严重的代谢紊乱发生。 结论 改良Indiana尿囊和Penn尿囊具有大容量、低内压以及较好的顺应性 ,是理想的可控性尿转流术 ,阑尾输出道的控尿效果优于回肠输出道更多还原

【Abstract】 Objective To evaluate the effect of modified Indiana pouch and Penn pouch in patients after cystectomy.Methods Twenty five patients underwent modified Indiana pouch (14 cases) and Penn pouch(11 cases) for contient urinary diversion,clinical effects(inculde continence,pressure and capacity) and complications were obseved.All patients were followed_up from 12 to 42 months(average 22.5 months).Results The average maximun capacity of modified Indiana pouch and Penn pouch were (461.18±67.89)ml and (482.73±59.79) ml 3 months after operation and mounted up to (626.83±61.56) ml and (593.27±71.35) ml 12 months aftr operation respectively.The average maximum pressure in modified Indiana pouch and Penn pouch were (1.80±0.46) kPa and (1.87±0.52)kPa 3 months after operation and down to (1.37±0.46)kPa and (1.23±0.32)kPa 12 months after operation.All 16 patients with appendix conduit got continence,2 of 9 patients with ileum conduit had partial incontinence.No ureter anastomotic stoma stricture and severe metabolic disturbance occurred.Conclusions The Indiana pouch and Penn pouch possesses high capacity,low intrinsic pressure and good compliance,they may be an ideal continent urinary diversions.Appendix conduit might be a better one than ileum.更多还原