不同尿流改道术对男性膀胱癌根治术后患者尿动力学参数、性功能及生活质量的影响

doi:10.3969/j.issn.1671-7171.2025.10.008

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摘要【目的】探讨不同尿流改道术对男性膀胱癌根治术后患者尿动力学参数、性功能及生活质量的影响。【方法】回顾性分析2024年1月至12月在本院行腹腔镜膀胱癌根治术治疗的90例男性患者的临床资料,根据尿道改流术的不同将患者分为观察组(采用原位回肠新膀胱术)和对照组(采用回肠膀胱术),每组45例。比较两组临床指标、尿动力学参数、性功能[国际勃起功能指数(IIEF-5)评分、亚利桑那性体验量表(ASEX)评分]、生活质量[健康调查量表(SF-36)评分]。【结果】两组术中出血量、住院时间、肠道功能恢复时间比较,差异无统计学意义(P>0.05),观察组手术时间长于对照组,差异有统计学意义(P<0.05)。两组术后新膀胱容量、术后残余尿量比较,差异无统计学意义(P>0.05)。观察组术后最大尿流率、术后日间尿控率、术后夜间尿控率均高于对照组(P<0.05)。术后,观察组IIEF-5评分高于对照组,ASEX评分低于对照组(P<0.05)。两组躯体疼痛、社会功能、情感职能评分比较,差异无统计学意义(P>0.05)。观察组生理功能、生理职能、总体健康、精神健康评分及总分均高于对照组(P<0.05)。【结论】原位回肠新膀胱术能够改善男性腹腔镜膀胱癌根治术后患者的尿动力学参数,对患者术后性功能和生活质量的影响较小。

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	张喜春

关键词 ：膀胱肿瘤, 膀胱切除术, 尿流改道术, 尿动力学, 生活质量

Abstract：【Objective】To explore the effects of different urinary diversion surgeries on urodynamic parameters, sexual function and quality of life in male patients after radical cystectomy for bladder cancer. 【Methods】The clinical data of 90 male patients who underwent laparoscopic radical cystectomy in our hospital from January 2024 to December 2024 were analyzed retrospectively. According to the type of urinary diversion surgery, the patients were divided into the observation group (undergoing orthotopic ileal neobladder surgery) and the control group (undergoing ileal conduit surgery), with 45 cases in each group. The clinical indicators, urodynamic parameters, sexual function [International Index of Erectile Function-5 (IIEF-5) score, Arizona Sexual Experience Scale (ASEX) score] and quality of life [36-Item Short Form Health Survey (SF-36) score] were compared between the two groups. 【Results】There were no statistically significant differences in intraoperative blood loss, hospital stay and intestinal function recovery time between the two groups (P>0.05), while the operation time of the observation group was longer than that of the control group, with a statistically significant difference (P<0.05). There were no statistically significant differences in postoperative neobladder capacity and postoperative residual urine volume between the two groups (P>0.05). The postoperative maximum urinary flow rate, daytime urinary control rate and nighttime urinary control rate in the observation group were all higher than those in the control group (P<0.05). After surgery, the IIEF-5 score of the observation group was higher than that of the control group, and the ASEX score was lower than that of the control group (P<0.05). There were no statistically significant differences in scores of bodily pain, social function and role-emotional between the two groups (P>0.05). The scores of physical function, role-physical, general health, mental health and total score in the observation group were all higher than those in the control group (P<0.05). 【Conclusion】Orthotopic ileal neobladder surgery can improve the urodynamic parameters of male patients undergoing laparoscopic radical cystectomy for bladder cancer, and has less impact on patients' postoperative sexual function and quality of life.

Key words： Urinary Bladder Neoplasms Cystectomy Urinary Diversion Urodynamics Quality of Life

收稿日期: 2024-05-27

中图分类号:

R737.14

引用本文:

张喜春. 不同尿流改道术对男性膀胱癌根治术后患者尿动力学参数、性功能及生活质量的影响[J]. 医学临床研究, 2025, 42(10): 1707-1710.
ZHANG Xichun. Effects of Different Urinary Diversion Surgeries on Urodynamic Parameters, Sexual Function and Quality of Life in Male Patients after Radical Cystectomy for Bladder Cancer. JOURNAL OF CLINICAL RESEARCH, 2025, 42(10): 1707-1710.

链接本文:

http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2025.10.008 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2025/V42/I10/1707

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