Bowel dysfunction after bladder reconstruction.
Bowel dysfunction after bladder reconstruction.
复制标题
膀胱重建后肠功能障碍。
DOI：
10.1097/00005392-199805000-00015
复制
发表时间：
1998
期刊：
影响因子：
--
通讯作者：
D. Neal
中科院分区：
文献类型：
--
作者：
J. N'Dow;H. Leung;C. Marshall;D. Neal
目的
使用肠段进行泌尿重建后，肠道功能可能会受到干扰。这种情况的病因及其在不同患者群体中的发病率尚不清楚。我们研究了因特发性逼尿肌不稳定而接受膀胱置换术、膀胱改道术、肠膀胱成形术和回肠导管改道术的患者中肠道紊乱的发生率。
材料和方法
我们对 71 例回肠导管改道后患者和 82 例膀胱重建后患者进行了评估，包括 28 例因逼尿肌不稳定而接受蛤肠膀胱成形术、26 例神经源性膀胱功能障碍和 28 例非神经性膀胱疾病。我们记录了症状的严重程度，如排便频率、夜间腹泻、肠胃气漏、大便急迫、大便失禁和爆发性腹泻，以及生活质量。
结果
在接受膀胱重建的患者中，24% 的患者术前出现肠道功能障碍症状，而术前无症状的患者中，42% 的患者术后出现新的肠道症状。因逼尿肌不稳定而接受蛤肠膀胱成形术的患者中，54% 的患者出现这些症状最常见且严重，而神经病变患者的这一比例为 26%，非神经病变患者的比例为 14%，回肠导管患者的比例为 15%。与其他组相比，因逼尿肌不稳定而接受肠囊成形术的患者夜间排便的发生率显着更高（18% vs 小于 4%，p <0.01）、肠胃气漏（29% vs 小于 8%，p <0.01）、大便急迫（39% vs 小于 12%，p <0.001）和大便失禁（32% vs 小于 16%，p <0.01）。 <0.001）。用于蛤肠膀胱成形术的回肠长度仅略长于用于回肠导管手术的回肠长度（25 厘米与 18 厘米）。在因逼尿肌不稳定而接受肠膀胱成形术的患者中，29% 由于随后的肠道症状而后悔接受该手术。
结论
逼尿肌不稳定的肠膀胱成形术后，患者有出现明显肠道症状的风险。新肠道症状的出现与患者满意度差有关。
PURPOSE
Bowel function may be disturbed after intestinal segments are used in urinary reconstruction. The etiology of this condition and its incidence in different patient groups is unclear. We studied the incidence of bowel disturbance in patients who underwent bladder replacement, continent diversion, enterocystoplasty for idiopathic detrusor instability and ileal conduit diversion.
MATERIALS AND METHODS
We evaluated 71 patients after ileal conduit diversion and 82 after bladder reconstruction, including clam enterocystoplasty for detrusor instability in 28, neurogenic bladder dysfunction in 26 and nonneuropathic conditions in 28. We noted the severity of symptoms, such as frequency of defecation, nocturnal diarrhea, flatus leakage, fecal urgency, fecal incontinence and explosive diarrhea, as well as quality of life.
RESULTS
Of the patients who underwent bladder reconstruction 24% had symptoms of bowel dysfunction preoperatively and 42% of those who were asymptomatic preoperatively described new bowel symptoms postoperatively. These symptoms were most common and severe in 54% of patients after clam enterocystoplasty for detrusor instability compared to 26% with neuropathy, 14% with a nonneuropathic condition and 15% with an ileal conduit. Compared to those in other groups patients who underwent enterocystoplasty for detrusor instability had a significantly higher incidence of nocturnal bowel movements (18 versus less than 4%, p <0.01), flatus leakage (29 versus less than 8%, p <0.01), fecal urgency (39 versus less than 12%, p <0.001) and fecal incontinence (32 versus less than 16%, p <0.001). The length of ileum used for clam enterocystoplasty was only slightly greater than that used for ileal conduit operations (25 versus 18 cm.). Of the patients who underwent enterocystoplasty for detrusor instability 29% regretted undergoing the procedure due to subsequent bowel symptoms.
CONCLUSIONS
After enterocystoplasty for detrusor instability patients are at risk of significant bowel symptoms. The development of new bowel symptoms was associated with poor patient satisfaction.
自述腹泻：这意味着什么？
DOI：
--
发表时间：
1994
期刊：
The American journal of gastroenterology
影响因子：
--
作者：
Talley,NJ;Weaver,AL;Zinsmeister,AR;Melton3rd,LJ
通讯作者：
Melton3rd,LJ