摘要
目的探讨中国人膀胱全切尿流改道术患者术后早期并发症及其危险因素。方法回顾性分析313例行膀胱全切尿流改道术的膀胱癌患者的术后早期并发症,对并发症进行分级和分类,采用Logistic回归分析术后早期并发症的危险因素。结果 313例膀胱癌膀胱全切术患者术后共118例(37.7%)出现159例次19种早期并发症,重度术后早期并发症占22.9%,死亡4例占总并发症的3.4%(4/118),死亡率为1.3%。并发症中术后不全性肠梗阻出现最多(27例次,17.0%),分类分析显示生殖泌尿系统相关并发症比例最高(59例次,37.1%)。回归分析示年龄(P=0.014)和ASA分级(P=0.019)是术后早期并发症的高危因素,而尿流重建方式并不影响术后早期并发症。结论膀胱癌膀胱全切尿流改道术术后早期并发症发生率较高,但重度并发症发生率低,死亡率低。膀胱癌患者的年龄、ASA评分、术后住院时间及输血量和术后早期并发症有关。
Objective To retrospectively review the 30-day postoperative complications of the bladder cancer patients following radical cystectomy（RC） in order to find some risk factors of these complications.Methods Clinical data of 313 consecutive RCs and urinary diversion who operated in our institute from January 2000 and October 2010,were collected.The 30-day postoperative complications were entered into a complication database and retrospectively reviewed for accuracy.Univariate regression models were used to define risk factors of complications.Results Of 313 patients,118（37.7%） experienced at least 1 complication within 30 d of surgery,and 159 episodes of 19 complications.Severe complications covered 22.9%.Four cases died,accounting for 3.4% of all complications（4/118） and 1.3% of mortality.Among all complications,incomplete ileus were most common（27 episodes,17.0%） followed by posterior urethral stricture（14.5%） and urinary leak（12.6%）.When complications were defined and stratified into 8 specific categories,genitourinary complications were most common（37.1%）.One univariate analysis showed age（P=0.014）and,American society of anesthesiologists（ASA） score（P=0.019）were most significant factors for complications,but not different ways of urinary diversion.Conclusion RC and urinary diversion for bladder cancer have a high rate of complications,but low rate of severe complications and mortality.Age,ASA score,postoperative stay and blood transfusion are high risk factors for postoperative complications.
出处
《第三军医大学学报》
CAS
CSCD
北大核心
2012年第7期651-653,共3页
Journal of Third Military Medical University
基金
第三军医大学临床创新基金(2010XLC02)~~
关键词
膀胱癌
膀胱全切术
术后并发症
危险因素
bladder cancer
radical cystectomy
postoperative complications
risk factors
