Cruz D N, Huot S J
Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, USA.
Am J Med. 1997 May;102(5):477-84. doi: 10.1016/S0002-9343(97)00020-X.
Patients with urinary diversions present unique challenges to internists who have an important role in their long-term management. Advances in surgical techniques over the past 30 years have given rise to a number of urinary diversion procedures that use various intestinal segments. In its normal function, the intestine absorbs water and solutes. When placed in contact with the urinary stream, the intestine can create numerous metabolic abnormalities. These include bone disease, hepatobiliary disease, infection, malignancy, neurologic complications, nutritional deficiencies, and a number of electrolyte and acid-base disorders. An overview of these metabolic abnormalities and their causes is provided, as well as recommendations for screening and management of patients.
尿路改道患者给内科医生带来了独特的挑战，内科医生在其长期管理中发挥着重要作用。在过去30年里，手术技术的进步催生了多种使用不同肠段的尿路改道手术。在正常功能中，肠道吸收水和溶质。当与尿液接触时，肠道会引发多种代谢异常。这些异常包括骨病、肝胆疾病、感染、恶性肿瘤、神经并发症、营养缺乏以及多种电解质和酸碱紊乱。本文概述了这些代谢异常及其成因，并给出了针对患者筛查和管理的建议。
