回肠膀胱术与原位回肠新膀胱尿流改道术术后患者健康相关生活质量研究.docVIP

回肠膀胱术与原位回肠新膀胱尿流改道术术后患者健康相关生活质量研究 　　[摘要] 目的 研究和探讨回肠膀胱术与原位回肠新膀胱尿流改道术在根治性膀胱全切术加尿流改道中的临床疗效，对两种方法在患者健康相关生活质量中的影响加以分析。 方法 选择2012年6月～2014年12月于本院行根治性膀胱全切术加尿流改道的患者98例作为研究对象，根据不同尿流改道方式分为两组各49例，分别给予原位回肠新膀胱术和回肠膀胱术，对比分析两组患者临床疗效，同时对患者进行至少3个月的随访，针对不同方法对健康相关生活质量的影响进行对比。 结果 两组在手术时间、术中出血量和住院时间方面差异均无统计学意义（P0.05）；回肠膀胱组早期并发症发生率为44.9%，原位回肠新膀胱组早期并发症发生率为49.0%，组间差异无统计学意义（P0.05）。失访18例，其中肿瘤复发转移死亡8例，非肿瘤原因死亡6例，其他原因失访4例。在随访期间发放FACT-BL调查问卷76份，回收有效问卷62份，有效回收率为79.5%，其中回肠膀胱组32份，原位回肠新膀胱组30份。原位回肠新膀胱组患者在躯体状况、家庭社会状况和膀胱癌模块等方面评分优于回肠膀胱组，差异有统计学意义（P0.05）；FACT-BL总分差异亦有统计学意义（P0.05）。 结论 针对膀胱癌进行根治性全切术加用回肠膀胱术与原位回肠新膀胱尿流改道术均能够有效解决临床问题，原位回肠新膀胱尿流改道术在提高患者生活质量方面具有一定的优势，应该根据患者个体化情况，综合患者个人意愿选择合适的方法。 　　[关键词] 回肠膀胱术；原位回肠新膀胱尿流改道术；膀胱癌；健康相关生活质量 　　[中图分类号] R737.14 [文献标识码] A [文章编号] 1674-4721（2015）06（a）-0067-04 　　Living quality research related to patient′s health after bricker operation and urinary diversion of orthotopic ileal neobladder 　　HUANG Jun-bo 　　Jiexi People′s Hospital，Guangdong Province，Jiexi 515400，China 　　[Abstract] Objective To study and explore the clinical effect of bricker operation and urinary diversion of orthotopic ileal neobladder in radical cystectomy and urinary diversion and analyze the influence of living quality relating to patient′s health by the two methods. Methods From June 2012 to December 2014，98 patients undergone radical cystectomy and urinary diversion in our hospital were selected as research objects.According to different urinary diversion modes，they were evenly divided in two groups and provided with orthotopic ileal neobladder and bricker operation.The clinical effectiveness in the two groups was compared and analyzed.Three-month follow up visits at least were needed targeting on comparing the influences of living quality relating to health by different therapeutic methods. Results There was no significant difference in operation time，intraoperative amount of bleeding，or hospital stay in both groups （P0.05）.Early-stage incidence of complications in the ileal bladder group was 44.9%，w