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本期繼續(xù)為大家分享歐洲泌尿外科學(xué)會視頻——膀胱切除術(shù)，包括回腸膀胱術(shù)與原位新膀胱術(shù)兩種，幫助病人將腎臟產(chǎn)生的尿液排出體外，本動(dòng)畫片生動(dòng)形象地展示了膀胱切除術(shù)整個(gè)過程。同時(shí)附上英文資料，以供大家更好地學(xué)習(xí)、交流。

醫(yī)生建議患者將膀胱切除，這種手術(shù)叫“膀胱切除術(shù)”。男性的膀胱全切術(shù)包括切除前列腺，女性的膀胱全切術(shù)一般包括切除子宮、卵巢以及部分陰道。切除膀胱時(shí)，醫(yī)生需將輸尿管與膀胱分離，輸尿管即連接腎臟與膀胱，用于輸送尿液的管道。手術(shù)還需要將尿道與膀胱分離，尿道即從膀胱通向體外的管道，用于排尿。這一手術(shù)中，可能也會切除淋巴結(jié)。膀胱切除后，醫(yī)生需要為病人設(shè)置新的引流裝置，幫助病人將腎臟產(chǎn)生的尿液排出體外。

本動(dòng)畫展示了兩種常用的排尿方法：回腸膀胱術(shù)與原位新膀胱術(shù)。

第一種：回腸膀胱術(shù)

回腸膀胱即重新設(shè)置一個(gè)排尿?qū)Ч�，利用患者體內(nèi)一段回腸進(jìn)行手術(shù)，導(dǎo)管一端連接輸尿管，即連接腎臟，用于輸送尿液的管道，另一端連接肚子上的切口，學(xué)名“造口”或“腹壁造口”，尿液積聚到連接在造口上的掛袋上，掛袋中尿液積滿后需手動(dòng)清空，醫(yī)生會指導(dǎo)病人學(xué)習(xí)如何倒掛袋。

第二種：原位新膀胱術(shù)

原位新膀胱術(shù)或“新膀胱”是縫合患者本身的一段小腸放在原膀胱的位置，存儲尿液。新膀胱的一端連接輸尿管，另一端連接尿道，與原膀胱一樣，尿液通過尿道排出體外。

醫(yī)生或?qū)�業(yè)護(hù)士會在患者出院后繼續(xù)提供護(hù)理指導(dǎo)，包括指導(dǎo)患者應(yīng)對在尿流改道后帶來的新出現(xiàn)的問題與挑戰(zhàn)。

English Subtitles

Your doctor has recommended that your bladder be removed.This surgery is called a “cystectomy”.In men, complete bladder removal includes removal of the prostate.In women, complete bladder removal typically includes removal of the uterus, ovaries and part of the vagina as well.To remove the bladder, the surgeon must separate both ureters from the bladder,the tubes that carry urine from the kidneys to the bladder.The surgeon will also separate the urethra from the bladder.The urethra carries urine from the bladder, out of the body.During the procedure, the lymph nodes may be removed as well.Once the bladder is removed, the surgeon will need to make a new way for passing urine from the kidneys to the outside of your body.

This animation show the two most common ways to pass urine: the ileal conduit and the neobladder.

Type 1. The ileal conduit

The ileal conduit is a new tube to carry urine.It is made from a section of your intestine.The conduit runs from the ureters, the tubes that carry urine from your kidneys,to an opening in your belly called a “stoma” or a “urostoma”.Urine is collected in a small bag placed over the stoma.The bag will need to be emptied when it is full.You will be given instructions on how to change the bag.

Type 2. The neobladder

A neobladder or “new bladder” is a pouch created from a portion of your intestines to store urine inside your body.The ureters are connected to one end of the neobladder.The urethra connects to the other end, just like in your original bladder.

You will pass urine through the urethra.

Follow-up care is provided by your doctor or a specialist nurse after you leave the hospital.This will include educational lessons on hope to cope with the challenges that come with a urinary diversion.

責(zé)任編輯：榭小仙