摘要
目的:探讨腹腔镜下膀胱根治性切除及尿流改道术后发生肠梗阻的相关危险因素。方法:回顾分析我院2012年1月~2016年7月期间行腹腔镜下膀胱根治性切除+尿流改道术116例患者的临床特征与术后肠梗阻之间的相关性。结果:14例(12.1%)患者术后发生肠梗阻,与无肠梗阻患者比较,肠梗阻患者年龄较大(均值73.07岁vs.67.68岁,P=0.045),体重指数(BMI)偏大(均值24.95kg/m^2 vs.23.68kg/m^2,P=0.006),有腹部手术史患者肠梗阻发生率更高[50%(7/14)vs.19.6%(20/102),P=0.029];术后肠梗阻与性别、术前血红蛋白及血肌酐、手术时间、术中失血量、淋巴结清扫、尿流改道方式、术后白蛋白、血电解质、肿瘤病理分期等因素均无相关性;多因素回归分析显示年龄(OR=0.900,95%CI 0.828~0.978,P=0.013)、BMI(OR=0.441,95%CI0.271~0.717,P=0.001)、腹部手术史(OR=10.206,95%CI 2.320~44.905,P=0.002)与术后肠梗阻的发生具有相关性。结论:腹腔镜下膀胱根治性切除及尿流改道术后肠梗阻的发生与年龄、BMI、腹部手术史显著相关,高龄和肥胖患者术后发生肠梗阻的危险性增加,且有腹部手术史者肠梗阻发生率更高。
Objective：To analyze the risk factors of ileus after laparoscopic radical cystectomy and urinary diversion.Method：In the retrospective study,116 patients who received laparoscopic radical cystectomy and urinary diversion from January 2012 to July 2016 were reviewed.The correlation between the clinical characters and the occurrence of postoperative ileus was identified.Result：Fourteen patients（12.1%）developed postoperative ileus.The postoperative ileus was significantly correlated with the patients＇ age（73.07 vs.67.68,P=0.045）,body mass index（24.95kg/m-2 vs.23.68kg/m-2,P=0.006）,previous abdominal operations[50%（7/14）vs.19.6%（20/102）,P=0.029].There was no significant correlation between the postoperative ileus and the patients＇ gender,preoperative hemoglobin and serum creatinine,operation time,intraoperative blood loss,urinary diversion,lymph node dissection,postoperative albumin,blood electrolyte or pathological stage.On multivariate analysis,age（OR=0.900,95%CI 0.828-0.978,P=0.013）,body mass index（OR=0.441,95% CI 0.271-0.717,P=0.001）and previous abdominal operations（OR=10.206,95%CI 2.320-44.905,P=0.002）were significantly correlated with the presence of the postoperative ileus.Conclusion：Increasing age,increasing BMI and previous abdominal operations were significantly correlated with the presence of postoperative ileus in patients undergoing laparoscopic radical cystectomy and urinary diversion.
出处
《临床泌尿外科杂志》
2017年第7期533-537,共5页
Journal of Clinical Urology
