根治性膀胱切除并回肠膀胱术不同术前肠道准备措施的效果比较

于靳; 胡敏; 许珊; 李旭楠; 郑亮

doi:10.7619/jcmp.201924024

根治性膀胱切除并回肠膀胱术不同术前肠道准备措施的效果比较

Comparison of different bowel preparation methods in radical cystectomy and ileal conduit

摘要

摘要:
目的比较3种全肠道清洁方法应用于根治性膀胱切除并回肠膀胱术前肠道准备的效果。
方法选择2012年3月—2018年11月行根治性膀胱切除并回肠膀胱术的46例患者作为研究对象，其中2012年3月—2016年2月的患者设为A组, 2016年3月—2018年1月的患者设为B组, 2018年2—11月的患者设为C组, A组术前接受传统肠道准备(TBP), B组术前接受快速肠道准备(RBP), C组术前接受肠内营养(EN)。比较3组患者术后肠道功能恢复时间、肠道清洁度、耐受性及不良反应的差异。
结果 C组患者的术后肠道恢复蠕动时间、术后通气时间均优于A组、B组患者，差异有统计学意义(P < 0.05); 3组患者术中肠道清洁度比较，差异无统计学意义(P>0.05); A组、B组患者术后并发症发生率比较，差异无统计学意义(P>0.05)。
结论 RBP方案应用于膀胱根治性切除并回肠膀胱术前肠道准备中安全有效, EN方案的肠道清洁度与TBP、RBP方案基本一致，但在患者可耐受性、术后肠道蠕动恢复时间、术后肛门排气时间方面均优于TBP、RBP方案，推荐用于膀胱根治性切除并回肠膀胱术前的肠道准备。

Abstract:
Objective To compare the effect of three bowel preparation methods in radical cystectomy and ileal cystoplasty.
Methods A total of 46 patients scheduled for radical cystectomy and ileal conduit from March 2012 to November 2018 were selected as study objects, and were divided into group A from March 2012 to February 2016, traditional bowel preparation (TBP), group B from March 2016 to January 2018, rapid bowel preparation (RBP), and group C from February to November 2018, enteral nutrition (EN). The recovery time of intestinal function, intestinal cleanliness, tolerance and adverse reactions were compared among the three groups.
Results The recovery time of intestinal function in group C were significantly better than the other two groups(P < 0.05). No significant difference was found in intestinal clearance in three groups and postoperative complications between group A and group B(P>0.05).
Conclusions RBP method is safe and effective in preoperative bowel preparation for radical cystectomy and ileal conduit. EN method is as the same efficacy as the TBP and RBP in intestinal clearance, but is better in terms of time to flatus and bowel movement as well as tolerance than TBP and RBP, and can be recommended to as bowel preparationbefore radical cystectomy and ileal conduit.

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