腹腔镜回肠膀胱扩大术治疗低顺应性膀胱的有效性和 .doc

腹腔镜回肠膀胱扩大术治疗的 王莉萍* 潘旭娟 袁晓晴 浙江省人民医院泌尿外科 浙江 杭州 310014 *通讯作者：，@163.com，手机【摘要】目的 探讨腹腔镜回肠膀胱扩大术治疗的。方法 回顾性分析2011年6月至2013年12月收治的22例接受腹腔镜下回肠膀胱扩大术式治疗的高反射低顺应性患者的资料，对术中、围手术期并发症进行观察评价，对术前、术后3、6、12、18、24个月患者的血肌酐水平、肾积水情况、肾小球滤过率以及尿动力学检查参数SPSS20.0软件进行统计学分析数据结果釆用均数士标准差(±s)表示各参数的差异P0.05为差异有统计学意义腹腔镜回肠膀胱扩大术治疗结果 本组22例，年龄22～62岁，病程1～15年，手术均在腹腔镜下顺利完成，术后肠道功能恢复时间2.5±0.7天，术后住院时间15.0±4.2天，术后均未发生回肠吻合口瘘、肠梗阻、严重腹腔感染或败血症等并发症。 17例患者随访12个月患者膀胱容量103.0±38.2ml增至术后403.0±45.8 ml（P=0.000），膀胱顺应性9.6±3.1cmH2O增至术后 38.1±4.4cmH2O(P=0.000)；压力16.5±6.4 cmH2O较术前45.3±15.8cmH2O明显降低(P)；血肌酐水平从术前183.±32.2 μmol/L 降至术后120.0±28.4 μmol/L（P）；总肾小球滤过率从术前40.0±25.5 ml/min/1.73m2升至术后62.0±28.6 ml/min/1.73m2 (P0.015)。3例泌尿系结核膀胱挛缩患者的最大尿流率明显增加，残余尿量有所减少，另有4例女性患者术后恢复自行排尿。结论 腹腔镜下回肠膀胱扩大术治疗安全可行，具有创伤小、出血少、肠道功能恢复快、术后并发症较少等优点，术后膀胱功能改善明显，可有效保护患者的上尿路功能。腹腔镜回肠膀胱扩大术治疗【关键词】腹腔镜；回肠膀胱扩大术；；尿流动力学 The preliminary clinical results using laparoscopic ileum augmentation cystoplasty for low compliance bladder and clinical nursing Wang Li-ping*, Pan Xu-juan, Zhu Xiao lin, Department of urology, Zhejiang Provincial People’s Hospital，Hangzhou 310014, Zhejiang Province, China * Corresponding author: Wang Li-ping*, wengwangliping@163.comAbstract: Objective:To investigate the efficacy and safety of laparoscopic ileum augmentation cystoplasty for low compliance bladder and clinical nursing . Method: From June 2011 to December 2013, 22 patients with hyperreflexia and low compliance bladder underwent laparoscopic ileum augmentation cystoplasty, the intraoperative and perioperative complications were observed and recorded. We collected the data of these patients’ hydronephrosis degree, serum creatinine, glomerular filtration rate and urine dynamics results at pre-operation and 3, 6, 12, 18, 24, 36 months?after operation and conducted statistical analysis using SPSS20.0 software. The results was showed in form of mean and standar