摘要
目的:尝试采用可控性尿路改道术治疗因外伤、手术后并发症而导致的膀胱颈部后尿道狭窄闭塞、膀胱挛缩、肾盂输尿管返流以及严重尿失禁。方法:对于膀胱容量基本正常者,采用膀胱前壁肌瓣形成肌管斜行通过腹直肌的方式,形成膀胱可控性造口;对于膀胱颈部后尿道狭窄闭塞、膀胱挛缩、肾盂输尿管返流者,采取阑尾原位脐造口可控性肠代膀胱术,输尿管与肠代膀胱粘膜下隧道吻合,旷置原来的膀胱和尿道。结果:两种术式术后患者膀胱或肠代膀胱均控尿能力良好,造瘘口无须覆盖,未发生感染。患者自我插管方便顺利。结论:可控性尿路改道不仅适用于中晚期的膀胱肿瘤患者的膀胱替代,也可以用于下尿路功能严重障碍者膀胱和尿道的暂时性或永久性替代。
Objective:To use continent urinary diversions to treat serious posttraumatic or postoperative compli- cations,such as urinary incontinence,urethral stenosis,bladder contracture,ureteral reflux,etc.Methods:When the bladder volume was nearly normal,a tube was formed with anterior wall of the bladder,and it was led out by traversing obliquely through the rectus muscle.The appendix with its tip cut open and led through the umbilicus as a conduit was used to treat a long urethral stenosis,bladder contracture,or ureteral reflux as sequelae of pelvic trauma or operations.Results;All the patients had obtained a complete urinary continence,with convenient inter- mittent catheterization without wetting after the operation.Conclusions:Continent urinary diversions could be a- chieved in the patients who suffered from bladder malignant tumor and those with serious urinary complications af- ter trauma and operation temporarily or permanently.
出处
《感染．炎症．修复》
2002年第1期37-39,共3页
Infection Inflammation Repair
关键词
尿失禁
尿道闭塞
膀胱挛缩
可控性
尿路改道
Urinary diversion
Urinary incontinence
Bladder shrinkage
Urethral obstruction
Ureteral reflux
