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膀胱为贮存尿液之肌性空腔器官,具有很大的收缩性,平均容量为300—500毫升,可控制地将贮存在膀胱内的尿液排出。当由于膀胱肿瘤等原因,膀胱必须切除或膀胱已不能起到尿液的贮存和排出作用时,利用肠道等作尿流改道势在必行。尿流改道术可分为不可控性和可控性二大类。不可控性尿流改道,以1950年Bricker报道的回肠代膀胱水和1965年Mogg报道的结肠代膀胱术为代表。这类手术的最大缺点是腹壁造口漏尿,给病人生活上带来不便,不易被患者按受。其优点是由于尿粪分流,减少了上行感染及电解质紊乱,早期观察以上二种手术方法对上尿路的保护是满意的,但是远期随访结果令人失望。
Bladder is the storage of urine of the muscular cavity organs, with great contractility, with an average capacity of 300-500 ml, controllable discharge of urine stored in the bladder. When due to bladder cancer and other reasons, the bladder must be removed or the bladder can not play the role of urine storage and discharge, the use of the gut for urinary diversion is imperative. Urinary diversion can be divided into two categories of uncontrollable and controllable. Uncontrolled urinary diversion was represented by ileal hydrostatic fluid reported by Bricker in 1950 and colonic neobladder reported by Mogg in 1965. The biggest drawback of this type of surgery is the stoma leakage of the abdominal wall, causing inconvenience to the patient’s life, not easily affected by the patient. The advantage is due to shunt urinary excretion, reducing the upstream infection and electrolyte imbalance, early observation of the above two surgical methods of upper urinary tract protection is satisfactory, but the long-term follow-up results disappointing.