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目的探讨腹腔镜膀胱全切除、原位回肠新膀胱的临床效果。方法对8例行腹腔镜膀胱全切除、原位回肠新膀胱患者进行排尿情况的记录和尿动力学检查。结果8例患者均可自主控制排尿(1例夜间轻微尿失禁),在新膀胱充盈过程中均可出现胀痛感觉,膀胱平均容量377.5ml,压力17.9cmH2O,最大尿流率18.1ml/s,最大尿道闭合压68.5cmH2O,功能性尿道长度3.7cm。结论腹腔镜根治性全膀胱切除、原位回肠新膀胱术较传统的开放手术创伤更小,但贮尿囊一样具有容积较大、内压较低和可控性较好的优点,排尿良好,值得临床推广。
Objective To investigate the clinical effect of total laparoscopic resection of bladder and ileum neo-bladder. Methods 8 cases of laparoscopic total cystectomy, ileum patients with urinary bladder urinary records and urodynamic examination. Results All 8 patients were able to control urination independently (one case of nocturnal incontinence). All patients had pain sensation in the process of neovascularization. The average volume of bladder was 377.5ml, pressure was 17.9cmH2O and the maximum flow rate was 18.1ml / s. Maximum urethral closure pressure 68.5cmH2O, functional urethral length 3.7cm. Conclusions Laparoscopic radical cystectomy and ileal neo-neo-bladder surgery are less invasive than traditional open surgery. However, the storage of urinary bladder has the advantages of larger volume, lower internal pressure and better controllability, good urination, Worth clinical promotion.