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The urodynamic evaluation of bladder augmentation using de-epithelialized segment of small intestine lined with urothelium
Author(s): SUN Xiaobing, ZHANG Li, CHEN Yuli, LI Jinliang, CHEN Weixiu
Pages: 599-
601
Year: 2004
Issue:
9
Journal: CHINESE JOURNAL OF UROLOGY
Keyword: 膀胱扩大术; 尿动力学;
Abstract: 目的评价利用膀胱黏膜双层小肠浆肌层膀胱扩大术后的尿动力学表现.方法25例逼尿肌反射亢进型神经性膀胱患者行利用膀胱黏膜的小肠浆肌层膀胱扩大术.男16例,女9例.年龄4~14岁.21例获随访6~24个月.手术前后行IVU、尿动力学检查及临床评价.结果手术后膀胱容量(242.62±60.04)ml、膀胱顺应性(8.10±3.00)ml/cmH2O(1 cmH2O=0.098kPa)、最大尿流率(7.60±2.90)ml/s均较术前[分别为(142.14±45.88)ml、(3.26±1.57)ml/cmH2O、(3.00±1.00)ml/s]增加,逼尿肌压力降低[术前(52.00±14.11)cmH2O、术后(33.33±15.39)cmH2O],剩余尿/膀胱容量较术前减小(术前0.33±0.11、术后0.16±0.10),P均<0.01.逼尿肌括约肌不协调和尿道闭合压无改变,无抑制收缩减轻.7例恢复尿意,9例输尿管返流减轻.结论利用膀胱黏膜的双层肠浆肌层膀胱扩大术可增加膀胱容量及顺应性,降低逼尿肌压,减轻逼尿肌反射亢进的程度.逼尿肌括约肌不协调、逼尿肌反射亢进、尿道闭合压低是影响临床结果的主要因素.
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