高龄患者行膀胱癌根治术后的疗效分析及预后危险因素探讨  

Clinical outcomes and risk factors for prognosis of radical cystectomy in elderly patients

作　　者：曾蜀雄[1] 宋瑞祥[1] 张振声[1] 于晓雯[2] 李慧珍[1] 鲁欣[1] 韦荣超[1] 赵俊杰[1] 杨波[1] 高旭[1] 侯建国[1] 王林辉[1] 孙颖浩[1] 许传亮[1] 

机构地区：[1]第二军医大学长海医院泌尿外科,上海200433 [2]第二军医大学长海医院老年科

出　　处：《临床泌尿外科杂志》2014年第8期666-669,共4页Journal of Clinical Urology

基　　金：上海市卫生系统优秀人才培养计划(编号XBR2013076)

摘　　要：目的：探讨高龄患者（≥75岁）行根治性全膀胱切除手术的疗效及影响高龄患者全膀胱手术预后的危险因素。方法：收集2009年1月~2013年11月在我院行根治性全膀胱切除手术中年龄≥75岁且随访资料完整的患者46例,观察手术时间、术中出血量、术后临床数据、术后并发症,通过COX生存分析探讨影响高龄患者全膀胱术后预后的危险因素。结果：46例患者平均手术时间（372±110）min,中位出血量450ml。术后早期并发症发生率达43.5%（20/46）,后期并发症发生率为21.7%（12/46）,术后手术相关死亡率为4.3%（2/46）。COX生存分析发现肿瘤是否器官局限,淋巴结是否转移与患者术后预后有关。结论：对于能够耐受根治性全膀胱切除术的高龄患者,全膀胱切除治疗仍应为推荐方案。Objective：To evaluate the clinical outcomes of radical cystectomy for elderly patients（≥75years old）and explore the risk factors of its prognosis.Method：We retrospectively observed the demographic,perioperative and follow-up data of elderly patients（≥75years old）treated by radical cystectomy,and analyzed the risk factors of the prognosis by COX proportional hazard regression model.Result：The mean operative time was（372±110）min,and the median estimated blood loss was 450（300-1 500）ml.The corresponding rates of early complications,late complications and operation-related mortality rate were 43.5%,21.7%,4.3%,respectively.Univariate and multivariate COX analysis showed close correlations among the pathologic stage,lymph node pathology and the prognosis of elderly patients underwent radical cystectomy.Conclusion：For elderly patients who can tolerate surgery and anesthesia,radical cystectomy is recommended.

关 键 词：膀胱切除术 膀胱癌 并发症 高龄患者 危险因素 预后 

分 类 号：R737.14[医药卫生—肿瘤]