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作者对28例直肠癌根治术患者进行前瞻性,连续性尿流动力学检测,以探讨直肠癌根治术后排尿功能障碍的发生机制。结果表明MiIes手术后患者的尿流率降低、膀胱感觉减退(P<0.05)。而Dixon手术后患者的尿流率及膀胱感觉则无显著性变化(p>0.05)。肿瘤的分化程度、Dukes分期及距肛门的距离对术后排尿的影响不显著(P>0.05)。说明直肠癌根治术后排尿功能障碍的发生与神经损伤、膀胱移位及创伤性、无菌性膀胱周围炎有关;并提出积极开展保留植物神经的直肠癌根治手术是非常必要的。
The author of 28 patients with radical resection of rectal cancer patients with prospective, continuous urodynamic study to explore the pathogenesis of urinary dysfunction after radical resection of rectal cancer. The results showed that the urinary flow rate decreased and bladder sensation decreased after MiIes operation (P <0.05). There was no significant difference in urinary flow rate and bladder sensation between Dixon and postoperative patients (p> 0.05). The degree of tumor differentiation, Dukes stage and the distance from the anus had no significant effect on postoperative urination (P> 0.05). The results showed that the occurrence of urinary dysfunction after radical resection of the rectum was related to the nerve injury, bladder displacement and traumatic and sterile cystitis of the bladder. It was suggested that it is necessary to actively carry out the radical surgery of rectal cancer for preserving autonomic nerve.