后腹腔镜治疗无功能肾结核中转开放风险因素分析  

Risk factors related with retroperitoneal laparoscopic nephrectomy of nonfunctioning renal tuberculosis converted to open surgery

作　　者：徐博[1] 王晓庆[1] 郝元元[1] 陈岐辉[1] 芦志华[1] 王春喜[1] 

机构地区：[1]吉林大学白求恩第一医院泌尿外科,长春130000

出　　处：《重庆医科大学学报》2016年第2期205-209,共5页Journal of Chongqing Medical University

基　　金：吉林省卫生厅青年基金资助项目(编号:20120159)

摘　　要：目的:分析影响后腹腔镜下肾切除术治疗无功能肾结核中转开放的主要风险因素。方法:回顾性分析144例同一术者完成的后腹腔镜治疗无功能肾结核的临床资料。对患者的性别、年龄、体质指数(body mass index,BMI)、伴随疾病(高血压、糖尿病)、肾脏情况(患肾位置、患肾大小、是否钙化、患肾周围轻度渗出)、对侧肾脏积水情况、术前抗结核时间及术者经验等相关因素进行单因素和多因素logistic回归分析。结果:144例患者中,23例中转开放手术,余121例均成功。在单因素分析中,BMI(P=0.023)、合并糖尿病(P=0.003)、合并高血压(P=0.011)、患肾体积增大(P=0.032)是影响后腹腔镜治疗无功能肾结核中转开放的主要因素。多因素Logistic回归分析中,BMI≥30 kg/m^2、糖尿病、高血压、患肾体积增大显著增加了后腹腔镜治疗无功能肾结核中转开放风险。结论:BMI≥30 kg/m^2、合并糖尿病、合并高血压、患肾体积增大可显著增加后腹腔镜治疗无功能肾结核中转开放的风险。Objective：To investigate the risk factors affecting conversion to open surgery in retroperitoneal laparoscopic nephrectomy of nonfunctioning renal tuberculosis. Methods：The records of 144 patients undergone retroperitoneal laparoscopic nephrectomy procedure by a single surgeon were retrospectively reviewed. The following factors including age,sex,body mass index（BMI）,diabetes status,hypertension status,side of kidney,size of kidney,degree of calcification,mild perirenal exudation,contralateral hydronephrosis,the time of anti-tuberculosis,and surgeon experience were analyzed. Univariate analyses and multivariate step regression analyses were used for statistical assessment. Results：Twenty-three out of 144 patients were converted to open surgery. In the univariate analyses,BMI（P=0.023）,diabetes status（P=0.003）,hypertension status（P=0.011）,size of kidney（P=0.032）were the risk factors affecting conversion to open surgery in retroperitoneal laparoscopic nephrectomy of nonfunctioning renal tuberculosis. Multivariate stepwise regression analyses showed that BMI ≥30 kg/m^2,diabetes status,hypertension status and enlargement of kidney increased the risk of conversion to open surgery. Conclusion：BMI≥30 kg/m^2,diabetes status,enlargement of kidney are the risk factors that affecting conversion to open surgery in retroperitoneal laparoscopic nephrectomy of nonfunctioning renal tuberculosis.

关 键 词：肾切除术 后腹腔镜 肾结核 中转开放 风险因素 

分 类 号：R691.3[医药卫生—泌尿科学]