膀胱全切不同尿流改道术后患者生活质量的比较

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、原何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。方法采用简明健埭状况洲查问卷（MOS36一itemShortFormHealthSurvey，SF-36）对昆明医科大学第二附属医院2008--201041-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㈨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。

Comparison of quality of life of postoperative patients with different types of urinary diversion after radical cys- tectomy

Objective To evaluate therapeutic effects of ileal neobladder, sigmoid neobladder, cutaneous ureterostomy, continent urinary diversion in terms of the quality of life of postoperative patients, and to provide a reasonable basis fbr the evaluation of therapeutic method for the bladder tumor. Methods From 2008 to 2010,we consecutively performed urinary diversion after radical cystectomy in 81 patients at the Second Affiliated Hospital of Kunming Medical University. The MOS 36-item Short Form Health Survey（SF-36） questionnaire was applied to assess the quality of life of patients with uri- nary diversion at 6,12 and 24 months after the surgery,respectively. Results The patients had significantly higher scores for social functioning,role-emotional functioning, mental health with the orthotopic urinary diversion than those with the non-orthotopic urinary diversion（ P 〈 0.05 ） ： There were no statistically significant differences either between the ileal neo- bladder group and sigmoid neobladder group or between the cutaneous ureterostomy group and continent urinary diversion group （ P 〉0. 05 ）. Conclusion The orthotopic urinary diversion can provide patients with better quality of life than non- orthotopic urinary diversion.