经尿道膀胱肿瘤切除术穿孔相关危险因素分析  

Risk factors of bladder perforation during transurethral resection of bladder tumors

作　　者：穆中一[1] 李刚[1] 栾雪[1] 刘世博[1] 陈昂[1] 付成[1] 胡滨[1] 

机构地区：[1]辽宁省肿瘤医院泌尿外科,辽宁沈阳110042

出　　处：《现代泌尿外科杂志》2015年第6期399-401,共3页Journal of Modern Urology

摘　　要：目的分析经尿道膀胱肿瘤切除术穿孔相关危险因素。方法回顾性分析辽宁省肿瘤医院从2008年1月到2013年12月行初次经尿道膀胱肿瘤切除术的患者656例。收集的数据包括患者的年龄、性别、身体质量指数、肉眼血尿、肿瘤分期及分级、肿瘤数量、肿瘤切除重量,通过卡方检验或Fisher确切概率法进行统计分析。结果23例膀胱穿孔（3.5%）,腹膜外型穿孔占78.3%,腹膜内型穿孔占21.7%。膀胱穿孔的风险与性别（女性与男性分别为7.9%和2.0%,P〈0.001）,身体质量指数（〈25、25~30和〉30kg/m2分别为7.4%、2.7%和2.4%,P=0.033）、肿瘤分期（pTis、pTa、pT1、pT2分别为0.2%、1.6%、6.0%、6.3%,P=0.027）,肿瘤浸润深度（浅表和侵肌层分别为2.2%、6.2%,P=0.010）和切除肿瘤重量（〈2和〉20g分别为1.5%、3.5%,P=0.026）有关。患者年龄、肉眼血尿、肿瘤分级和肿瘤数量不是膀胱穿孔的危险因素。结论性别、体重指数、肿瘤分期、肿瘤浸润程度和肿瘤切除重量是经尿道膀胱肿瘤切除术穿孔相关危险因素。年龄、肉眼血尿、肿瘤的分级及肿瘤数量等没有影响膀胱穿孔。尤其是瘦小女性患者易穿孔。Objective To analyze the risk factors of bladder perforation for patients treated with transurethral resection of bladder tumors（TURBT）. Methods Clinical data of 656 patients with bladder cancer who underwent transurethral resec- tion of bladder tumors during 2008 to 2013 in our hospital were retrospectively analyzed. Data including age, gender, body mass index （BMI）, gross hematuria, tumor stage and grade, number of tumors and resection weight, were analyzed with the Pearson Chi-square （X^2） test or Fisher＇s exact probability test. Results Of the 23 （3.5 %） bladder perforations, 78.3 % were extraperitoneal and 21.7% were intraperitoneal. The risk of bladder perforation was associated with gender （7.9 % for female and 2.0 % for male, P〈0. 001）, BMI （7.4 % for those with BMI〈25, 2.7 % for those with BMI being 25-30, and 2.4 % for those with MBI〉30 kg/m2 , P=0.033）, tumor stage （0.2% for pTis, 1.6% for pTa, 6.0% for pT1 and 6.3% for pT2, P= 0.027）, infiltration depth （2.2% for superficial and 6.2% for muscle invasive, P=0. 010） and resection weight （1.5% for tumors %2 mg and 3.5% for tumors〉20 g, P=0. 026）. Patients＇ age, gross hematuria, tumor grade and number of tumors were not risk factors for bladder perforation. Oonclusions Gender, body mass index, tumor stage, tumor invasion and re- section weight are risk factors for bladder perforation during transurethral resection of bladder tumors. Thin and female pa- tients are especially vulnerable to bladder perforation. Age, gross hematuria, tumor grade and number of tumors are not associ- ated with bladder perforation.

关 键 词：膀胱肿瘤 经尿道膀胱肿瘤切除术 穿孔 危险因素 性别 身体质量指数 

分 类 号：R737[医药卫生—肿瘤]