膀胱癌根治术后早期并发症及其危险因素分析  

Risk factors for common early stage complications following radical cystectomy

作　　者：曾蜀雄[1] 宋瑞祥[1] 于晓雯[2] 张振声[1] 鲁欣[1] 李慧珍[1] 赵俊杰[1] 马重[1] 陈新[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》2015年第2期104-106,111,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：探讨膀胱癌根治术（RC）后早期并发症发病特点及常见并发症相关危险因素。方法：收集2009年10月~2014年1月我院行根治性全膀胱切除手术且随访资料完整的患者共294例,收集患者相关信息及术中、术后资料,统计患者术后90天内早期并发症,并应用二元逻辑回归统计方法探讨术后常见并发症的危险因素。结果：术后并发症发生发生率38.7%（114/294）,其中Clavien分级1级25例,2级74例,3级13例,5级2例。术后并发症以感染、肠梗阻、切口脂肪液化常见;老年（〉65岁）及肥胖（BMI〉25kg/m2）是术后肠梗阻发生的危险因素;开放式RC及糖尿病则是术后切口脂肪液化的危险因素。结论：RC术后并发症发生率较高,对于有发生肠梗阻或切口脂肪液化危险因素的患者,RC术前及术后应采取积极措施预防其发生。Objective：To explore the incidence and characteristics of early stage complications after radical cystectomy（RC）in our center,and analyze the risk factors of common complications after RC.Method：We retrospectively analyzed the demographic,perioperative and postoperative data of 294 patients who had undergone RC.We collected complications happened within 90 days after cystectomy.Univariate and multivariate logistic regression analyses were used to evaluate the association between the clinical characteristics and the common postoperative complications.Result：Of 294 patients,114developed early stage complications,among which 25 were Clavien grade one,74 were grade two,13 were grade three and two cases were grade five.The common complications following RC were infection,ileus and incision related complications.The risk factors for ileus and incision related complications were obese（BMI〉25kg/m2）,age（〉65years）and diabetes,open radical cystectomy,respectively.Conclusion：The complication rate after RC is relatively high,and arduous effort should be made to prevent ileus and incision related complications in those patients with risk factors.

关 键 词：膀胱癌 膀胱癌根治术 并发症 危险因素 

分 类 号：R737.14[医药卫生—肿瘤]