膀胱全切术后的尿流改道

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膀脆癌的预后评估,单靠细胞分化度,常发现级数相同,而预后悬殊,随着染色体的检查,已知有数目、结构异常或有瘤标者,预后较差,流式细胞计为这方面工作提供方便,没有这一设备的单位,短期直接细胞培养法、有一定帮助。2.手术治疗的改进:膀胧癌的手术治疗过去常分局部、部分或全切除术。但目前经尿道电切已取代了局切和部切,只有病变广泛者才用全切。关于膀脱全切后尿流改道的问题,回肠膀脱已沿用多年,可控性回肠膀胧近年来在倡用中。这些手术共同的缺点是手术繁复、创伤大、比较费时。摒弃多年的输尿管乙肠吻合术最近又受重视,具有手术简单,创伤小、韦省时间等优点,至于电解质紊乱及尿感并发症,只要病例选择合适、及时的预防治疗,是可以避免或纠正的。3.膀脆腔内灌注疗法:表浅膀胧痛及原位癌采用抗癌药及免疫制剂作定期腔内灌注,有一定疗效,愈来愈受重视,虽然免疫制剂灌注的作用机制,尚在深人研究中,但被认为是具有前景的疗法。本刊约清国内一些专家,讨论这些方面的问题,希望能引起临床工作者的注意,并作为实际工作的参考。 The prognosis assessment of bladder cancer depends on the degree of cell differentiation, often found in the same series, but the prognosis is poor, with the chromosome examination, known to have a number of structural abnormalities or tumor markers, poor prognosis, flow cytometry For this aspect of work to provide convenience, without this unit of equipment, short-term direct cell culture, there is some help. 2. Surgical treatment improvements: Surgical treatment of bladder cancer in the past often sub-partial, partial or total resection. However, transurethral transurethral resection has been replaced by partial and partial cut, only a wide range of lesions were cut. On the whole removal of bladder flow diversion problems, ileal bladder off has been used for many years, controlled ileal bladder in recent years in the promotion. The common disadvantage of these operations is complicated surgery, trauma, more time-consuming. Abandonment of ureteral anastomosis for many years has recently received attention, with the advantages of simple operation, less trauma, Wei time, etc., as electrolyte disorders and urinary tract complications, as long as the appropriate choice of cases, timely prevention and treatment can be avoided or corrected of. 3. Intrapleural infusion therapy: superficial bladder pain and cancer in situ using anticancer drugs and immune agents for regular intraluminal perfusion, have a certain effect, more and more attention, although the role of immune agents perfusion mechanism, yet In deep research, but is considered to have promising therapies. This journal about Qing experts to discuss these issues, hoping to attract the attention of clinicians, and as a reference to the actual work.
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