关键词：膀胱肿瘤；癌；尿路分流术
摘要 为客观地评价回肠新膀胱术的远期疗效，对52例术后病人的可控性、尿动力学、肾功能、贮尿囊组织学变化及尿sIgA等进行随访研究。49例获随访3～66个月，平均随访35个月。日间可控率为94%，夜间为81%。平均最大膀胱容积为424.5ml，最大内压为2.70kPa(1kPa=10.20cmH2 O)，平均剩余尿24.8ml，最大尿流率为18.0ml/s。IVU示8例11条输尿管轻中度扩张，膀胱造影2例轻度返流，血肌酐、尿素氮保持正常，尿NAG2例升高。术后病人尿sIgA较高。随术后时间延长，贮尿囊绒毛及微绒毛逐渐萎缩，酸中毒发生率下降，尿内粘液减少。肿瘤尿道复发1例。认为回肠新膀胱术是一种可选择的手术。
A follow up study of ilealneobladder Xu Hongyi,Qiu Xuede,ShiYongfu,et al.Department of Urology,the Second Affiliated Hospital,Kunming MedicalCollege,Kunming 650101
Abstract 49 of 52 cases of ileal neobladder have been followed up for a meanof 35 months.Day continence has been achieved in 94% and night time continence in 81%.Themean maximum bladder capacity has been 424.5ml and the mean intravesical pressure 27.5cmH2 O.Themean maximum flow rate has been 18.0ml and the residual urine 24.8ml.On IVU 11 ureters in8 patients (15%) revealed slight or medium dilatation and 2 patients (4%) revealed mildreflux on cystourethrography.Urinary NAG was elevated in 2 cases (4%).Higher level ofurinary sIgA was observed in all the patients.As time went by,hyperchloremic acidosisbecame less because of the atrophy of the ileal villi and microvilli.Tumor recurrence hasbeen detected in one patient (2%).It was concluded that ileal neobladder is feasible forclinical application.
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