原位乙状结肠新膀胱20例尿动力学分析

目的：从尿动力学角度阐明乙状结肠原位新膀胱的尿动力学特点，为该术式提供尿动力学依据。方法：2000年1月～2006年3月间对乙状结肠原位新膀胱术的20例患者进行随访，并获得尿动力学检测等资料。结果：随访期间发现，代膀胱容量逐渐增大，而充盈期最大压力逐渐减低；最大尿流率也逐渐增大，而排尿期最大压力和剩余尿量逐渐减少；膀胱颈压和最大尿道压逐渐增大；上述指标在术后3～6个月开始稳定在正常水平。随访期间均无肾积水，未见输尿管梗阻及反流，血清电解质及肾功能均正常。结论：乙状结肠原位新膀胱术储尿囊具有较好的顺应性，适当容量，一定的低压和良好的抗反流作用；而术后进行膀胱功能训练是必要和有益的，观察发现3-6个月基本恢复稳定的代膀胱功能，且患者具有较好的生活质量。

Urodynamic Analysis of 20 Orthotopic Sigmoid Neobladders

Objective：To investigate the urodynamic characteristics of the orthotopic sigmoid neobladders and to provide urodynamic parameters for orthotopic sigmoid neobladders. Methods：From January 2000 to March 2006, 20 cases underwent orthotopic sigmoid neobladders were followed up. Data of urodynamic determination were acquired. Results： The maximum capacity of neobladder became more and more larger, but maximum pressure in fill ing period degraded. The maximum urine flow accreted, but maximum pressure in urinating period and residual u fine volume reduced. Bladder neck pressure and maximal urethral pressure accreted . Above mentioned indexes be came stable in the normal level 3-6 months after operation. In the following-up period, there were no case of hydronephrosis, obstruction of ureter and back flow. Serum electrolytes and renal function are normal. Conclusions： Orthotopic sigmoid neobladders had better compliance, sufficient capacity , lower intravesieal pressure and satisfactory anti-backstreaming effect. Neobladder function training was necessary and beneficial. The patients gained stable neobladder functions 3-6 months after operation and had good quality of life.