摘要
目的:评估综合并发症指数(CCI)在铥激光前列腺剜除术(ThuLEP)术后并发症评估中的应用,并将其与Clavien-Dindo(CDC)分级系统进行对比。方法:回顾性分析2019年8月至2021年10月北京清华长庚医院泌尿外科因良性前列腺增生行ThuLEP手术的283例住院患者的临床资料,分别使用CDC和CCI两种并发症评价体系对患者术后并发症进行评估,并分析两者与术后住院时间的相关性。结果:73例(25.60%)患者共出现80次并发症。CDC分级结果显示Ⅰ级并发症59例(20.85%),Ⅱ级13例(4.59%),Ⅲa级4例(1.41%),Ⅲb级3例(1.06%),Ⅳa级1例(0.35%),无Ⅳb级和V级并发症发生。存在并发症患者累积CCI分值的中位数为8.7(8.7,33.7)分,7例患者发生≥2种并发症,其累积CCI分值高于CDC最高分级对应的CCI分值。两者均与术后住院时间显著正相关,即CDC分级越高,术后住院时间越长(r=0.34,P<0.001),累积CCI分值越高,术后住院时间也越长(r=0.58,P<0.001)。累积CCI分值与术后住院时间相关相关性更强。结论:CCI适用于ThuLEP术后短期并发症的评估,对比CDC可以更加准确地反映并发症的数量和对术后住院时间的影响。
Objective:To evaluate the use of the comprehensive complication index(CCI)in the evaluation of postoperative complications after thulium laser enucleation of the prostate(ThuLEP)and compare CCI with the Clavien-Dindo classification(CDC)grading system.Methods:The clinical data of 283 patients who underwent ThuLEP for benign prostatic hyperplasia(BPH)in the Department of Urology of Beijing Tsinghua Chang Gung Memorial Hospital from August 2019 to October 2021 were retrospectively analyzed.Patients were assessed for postoperative complications using the CDC and CCI complication evaluation systems respectively,and the correlation between the two and postoperative length of stay was analysed.Results:A total of 80 complications occurred in 73 patients(25.60%).The results of CDC classification showed grade I complications in 59 cases(20.85%),grade Ⅱ in 13 cases(4.59%),grade ⅢA in 4 cases(1.41%),grade ⅢB in 3 cases(1.06%),and grade ⅣA in 1 case(0.35%).No grade ⅣB or V complications occurred.The median cumulative CCI score for patients with complications was 8.7(8.7,33.7).A total of 7 patients had≥2 complications,and the cumulative CCI score was higher than the CCI score corresponding to the highest grade of CDC.Both of them were positively correlated with postoperative hospital stay,i.e.higher CDC grade,longer postoperative hospital stay(r=0.34,P<0.001),higher cumulative CCI score,and longer postoperative hospital stay(r=0.58,P<0.001).Cumulative CCI scores were more strongly correlated with postoperative hospital stay.Conclusion:Compared with CDC,CCI can be used more accurately to assess complications andtheir influence on postoperative hospital stay after ThuLEP.
作者
宋海峰
付猛
白文洁
李建兴
Song Haifeng;Fu Meng;Bai Wenjie;Li Jianxing(Department of Urology,Beijing Tsinghua Changgung Hospital,School of Clinical Medicine,Tsinghua University,Beijing102218,China)
出处
《微创泌尿外科杂志》
2022年第1期47-51,共5页
Journal of Minimally Invasive Urology
关键词
前列腺
手术后并发症
铥激光
prostate
post-operative complications
thulium laser
