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本期繼續為大家分享歐洲泌尿外科學會視頻——膀胱切除術，包括回腸膀胱術與原位新膀胱術兩種，幫助病人將腎臟產生的尿液排出體外，本動畫片生動形象地展示了膀胱切除術整個過程。同時附上英文資料，以供大家更好地學習、交流。

醫生建議患者將膀胱切除，這種手術叫“膀胱切除術”。男性的膀胱全切術包括切除前列腺，女性的膀胱全切術一般包括切除子宮、卵巢以及部分陰道。切除膀胱時，醫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。這一手術中，可能也會切除淋巴結。膀胱切除后，醫生需要為病人設置新的引流裝置，幫助病人將腎臟產生的尿液排出體外。

本動畫展示了兩種常用的排尿方法：回腸膀胱術與原位新膀胱術。

第一種：回腸膀胱術

回腸膀胱即重新設置一個排尿導管，利用患者體內一段回腸進行手術，導管一端連接輸尿管，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清空，醫生會指導病人學習如何倒掛袋。

第二種：原位新膀胱術

原位新膀胱術或“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。

醫生或專業護士會在患者出院后繼續提供護理指導，包括指導患者應對在尿流改道后帶來的新出現的問題與挑戰。

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.

責任編輯：榭小仙