299例膀胱全切术后早期并发症及危险因素分析  

Analysis of early postoperative complication following radical cystectomy and its related risk factors in 299 cases

作　　者：杨小明[1] 易成智 李帅[1] 杨阳[1] 师磊[1] 宋东奎[1] 

机构地区：[1]郑州大学第一附属医院泌尿外科,郑州450052

出　　处：《临床泌尿外科杂志》2016年第6期513-518,共6页Journal of Clinical Urology

基　　金：国家自然科学基金(编号81272823);河南省重点科技攻关计划项目(编号122102310547);河南省教育厅科技创新团队(编号14IRTSTHN020)

摘　　要：目的：了解膀胱全切术后并发症的发生率及严重程度,并分析其相关风险因素,以期为降低膀胱全切术后并发症的发生率提供帮助。方法：回顾性分析我院2010～2014年间299例行膀胱癌根治术患者的临床及随访资料,对并发症进行分级和分类,并分析术后并发症的相关危险因素。结果：膀胱全切术后早期并发症的发生率为70.2%,术后并发症主要为轻-中度并发症Ⅰ级（172例）和Ⅱ级（125例）,占78.8%;重度并发症Ⅲ级（71例）、Ⅳ级（7例）和Ⅴ级（2例）,占21.2%;死亡率为0.7%。并发症以肠梗阻60例（15.9%）、泌尿系感染46例（12.2%）、术后输血43例（11.4%）、切口相关42例（11.1%）为主要并发症,其余并发症发生率相对较低。结论：膀胱全切术后并发症发生率高、但以轻-中度并发症为主,死亡率较低,是比较安全的膀胱癌治疗方法;术前合并基础疾病（高血压病、糖尿病、冠心病等）、尿流改道术式是其术后并发症的危险因素。Objective：To explore the incidence and severity of complications and analyse the risk factors related to the complications hoping to provide some help in reducing the incidence of the postoperative complications for bladder cancer patients.Method：From 2010 to 2014,299 patients with bladder cancer underwent radical cystectomy and urinary diversion in our department.The clinical data were retrospectively analyzed.Also,we graded and classified the complications,analyzed the related risk factors for postoperative complications.Result：The incidence of perioperative complications was 70.2%.Complications were classified as Clavien typeⅠ（172cases）,Ⅱ（125cases）,Ⅲ（71cases）,Ⅳ（7cases）,Ⅴ（2cases）.Mortality was 0.7%.The common complications were paralytic ileus（60cases）,urinary system infection（46cases）,blood transfusion（43cases）and incision-related complications（42cases）.Other complications are uncommon.Conclusion：For patients with bladder cancer radical cystectomy is safe.The incidence of complications is high,but most of them are low-medium grade.Morbidities（hypertension,diabetes,coronary heart disease,etc.）and urinary diversion are the risk factors of postoperative complications.

关 键 词：膀胱癌 根治性膀胱全切术 风险因素 

分 类 号：R737.14[医药卫生—肿瘤]