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输尿管造口术袋在根治性膀胱切除术后围手术期尿液渗漏管理中的应用。

Use of urostomy bags in the management of perioperative urine leakage after radical cystectomy.

作者信息

Li Xuemei, Fang Qiang, Ji Huixiang, Pan Jinhong, Zhang Jing, Li Zhenyan, Chen Min, Wu Xiaojun, Zhou Zhansong, Chen Zhiwen

机构信息

Author Affiliations: Section of Urological Oncology, Urology Institute of the People's Liberation Army, and Southwest Cancer Center, Southwest Hospital, Third Military Medical University, Chongqing, People's Republic of China.

出版信息

Cancer Nurs. 2014 May-Jun;37(3):170-4. doi: 10.1097/NCC.0b013e318277db29.

Abstract

BACKGROUND

Urine leakage is a common complication in patients with bladder cancer after radical cystectomy and neobladder reconstruction.

OBJECTIVE

The aim of this study was to evaluate the clinical value of the use of urostomy bags in the management of urine leakage in patients with bladder cancer after radical cystectomy.

METHODS

Urine leakage during the perioperative period was retrospectively analyzed in 483 patients with bladder cancer who underwent radical cystectomy from 2004 to 2010. Before 2008, all patients with urine leakages were treated by routine dressing changes (group A). After 2008, the leakages were managed with urostomy bags (group B). The perioperative quality of life (EQ-5D) and cost for urine leakage for both groups were compared in this controlled study.

RESULTS

The average cost in management of preoperative urine leakage was significantly higher in group A than in group B as well as the patients with extravasations of urine or lymphoceles. Patients in group B had an overall better perioperative life quality compared with group A. In particular, the score for pain/discomfort was significantly higher in group A than in group B.

CONCLUSIONS

The management of perioperative urine leakage with urostomy bags avoided constant body wetness and significantly increased the quality of life and reduced the special costs of urine leakage in patients with bladder cancer after cystectomy.

IMPLICATIONS FOR PRACTICE

Early use of urostomy bag is a good choice for perioperative urine leakage in patients with bladder cancer after radical cystectomy and neobladder reconstruction.

摘要

背景

尿漏是膀胱癌根治性膀胱切除术及新膀胱重建术后患者的常见并发症。

目的

本研究旨在评估造口袋在膀胱癌根治性膀胱切除术后患者尿漏管理中的临床价值。

方法

回顾性分析2004年至2010年接受根治性膀胱切除术的483例膀胱癌患者围手术期的尿漏情况。2008年前,所有尿漏患者均采用常规换药治疗(A组)。2008年后,采用造口袋处理尿漏(B组)。在这项对照研究中比较了两组患者围手术期的生活质量(EQ-5D)及尿漏处理费用。

结果

A组术前尿漏处理的平均费用显著高于B组,尿液外渗或淋巴囊肿患者也是如此。与A组相比,B组患者围手术期总体生活质量更好。特别是,A组疼痛/不适评分显著高于B组。

结论

膀胱癌根治性膀胱切除术后患者围手术期尿漏采用造口袋处理可避免身体持续潮湿,显著提高生活质量,降低尿漏专项费用。

实践意义

对于膀胱癌根治性膀胱切除术及新膀胱重建术后患者围手术期尿漏,早期使用造口袋是一个不错的选择。

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