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目的:研究在治疗神经源性低顺应性膀胱过程中乙状结肠膀胱扩大术的疗效。方法:对近几年在我院就诊的患者中随机挑选30例经保守治疗失败的神经源性低顺应性膀胱的患者,并对其使用乙状结肠膀胱扩大术,参与本次研究的病人需经过尿动力学检查、尿道膀胱镜以及膀胱造影进行确诊后方能进行手术。手术使用15至20厘米乙状结肠扩大膀胱,若患者有膀胱输尿管返流则需先进行相关手术,治疗结束后要定期寻访,对剩余尿量50ml以上或不能自行排尿的患者进行间歇性清洁导尿的辅助治疗。对病人治疗前后输尿管返流、储尿期最大逼尿肌压力、膀胱容量、肾功能以及尿失禁发生率等相关指标的改善情况进行比较,并对病人术后并发症的临床转归以及发生率进行分析。结果:本次研究中的30例病人在手术完成后,膀胱安全容量经由膀胱造影反应显示其容量增大,同时病人血清肌酐也恢复其正常水平;同时有16例患者出现并发症,经治疗后有所减轻。患者经由护理引导下大部分可以自行清洁导尿。结论:针对患者的膀胱容量问题,乙状结肠膀胱扩大术可以很好的进行解决,使膀胱充盈期的压力得到有效地降低,保证病人储尿环境的安全性,在临床对神经源性低顺应性膀胱进行治疗的有效方式,但治疗后或伴有泌尿系统感染。
Objective: To study the curative effect of sigmoid colon expansion in the treatment of neurogenic low compliance bladder. Methods: Thirty patients with conservative treatment failed neurogenic hypo-adaptive bladder were randomly selected from patients in our hospital in recent years. The patients undergoing sigmoid colon augmentation were enrolled in this study. Kinetic examination, urethral cystoscopy and cystography were confirmed before surgery. Surgical use of 15 to 20 cm sigmoid colon to expand the bladder, if the patient has vesicoureteral reflux related surgery to be carried out after the end of regular visits, the remaining urine output of 50ml or more than patients with intermittent urinary catheterization can be intermittent clean catheterization Assisted treatment. The changes of ureteral reflux, maximal detrusor pressure during storage, bladder capacity, renal function and the incidence of urinary incontinence were compared before and after treatment, and the clinical outcomes and incidence of postoperative complications Analyze. RESULTS: Thirty patients in this study completed the surgery and the capacity of the bladder was increased via cystography. At the same time, the patient’s serum creatinine returned to its normal level. At the same time, 16 patients developed complications. After treatment, Have eased. Most patients under the guidance of nursing can clean their own catheterization. Conclusion: In view of the patient’s bladder capacity, sigmoid colon expansion can be well resolved, so that the pressure during the bladder filling period is effectively reduced, to ensure the safety of the patient’s urine storage environment, in clinical neurogenic low compliance bladder An effective method of treatment, but after treatment or with urinary tract infections.