老年膀胱癌患者根治性膀胱切除术后泌尿系感染发生的影响因素  

Influencing factors of urinary infection after radical cystectomy in elderly patients with bladder cancer

作　　者：陈娟[1] 王一涵 唐叶 赵丹[1] 王璐[1] 王子明[1] Chen Juan;Wang Yihan;Tang Ye;Zhao Dan;Wang Lu;Wang Ziming(Department of Urology,Second Affiliated Hospital of Xi′an Jiaotong University,Xi′an 710004,China)

机构地区：[1]西安交通大学第二附属医院泌尿外科,西安710004

出　　处：《中国医师进修杂志》2024年第9期791-796,共6页Chinese Journal of Postgraduates of Medicine

基　　金：陕西省自然科学项目(S2023-JC-YB-0548)。

摘　　要：目的分析老年膀胱癌患者根治性膀胱切除术后泌尿系感染的影响因素。方法采用回顾性研究的方法,收集2020年3月至2023年2月西安交通大学第二附属医院行根治性膀胱切除术后发生泌尿系感染的56例老年膀胱癌患者临床资料,均纳入病例组,以1∶3比例收集168例根治性膀胱切除术后未发生泌尿系感染的患者为对照组。收集患者基线资料和围手术期资料,采用Logistic回归分析老年膀胱癌患者根治性膀胱切除术后泌尿系感染的影响因素。结果单因素分析结果显示,病例组糖尿病比例、肾积水比例、营养风险比例、吸入性麻醉比例、老年衰弱比例、应激性高血糖比例、白蛋白(ALB)<35 g/L比例、尿袋更换时间均高于对照组[66.07%(37/56)比44.64%(75/168)、69.64%(39/56)比46.43%(78/168)、66.07%(37/56)比41.67%(70/168)、73.21%(41/56)比48.81%(82/168)、55.36%(31/56)比35.12%(59/168)、41.07%(23/56)比20.24%(34/168)、55.36%(31/56)比36.90%(62/168)、(7.52±1.65)d比(6.62±1.44)d],差异有统计学意义(P<0.05)。Logistic回归分析结果显示,营养风险、吸入性麻醉、应激性高血糖、老年衰弱是老年膀胱癌患者根治性膀胱切除术后泌尿系感染的独立危险因素(P<0.05)。结论老年膀胱癌患者根治性膀胱切除术后泌尿系感染与营养风险、吸入性麻醉、应激性高血糖、老年衰弱密切相关,重视以上因素并行对症干预是防治泌尿系感染的重要内容。Objective To analyze the influencing factors of urinary infection after radical cystectomy in elderly patients with bladder cancer.Methods A retrospective study was conducted to collect the clinical data of 56 elderly patients with bladder cancer who developed urinary infection after radical cystectomy in the Second Affiliated Hospital of Xi′an Jiaotong University from March 2020 to February 2023.All patients were included in the case group.A total of 168 patients without urinary infection after radical cystectomy were collected at a ratio of 1∶3 into the control group.Baseline data and perioperative data were collected,and Logistic regression was used to analyze the influencing factors of urinary infection after radical cystectomy in elderly patients with bladder cancer.Results Single factor analysis showed that the diabetes proportion,hydronephrosis proportion,nutrition risk proportion,inhalation anesthesia proportion,senile weakness proportion,stress hyperglycemia proportion,albumin(ALB)<35 g/L proportion and urine bag replacement time in the case group were significantly higher than those in the control group:66.07%(37/56)vs.44.64%(75/168),69.64%(39/56)vs.46.43%(78/168),66.07%(37/56)vs.41.67%(70/168),73.21%(41/56)vs.48.81%(82/168),55.36%(31/56)vs.35.12%(59/168),41.07%(23/56)vs.20.24%(34/168),55.36%(31/56)vs.36.90%(62/168),(7.52±1.65)d vs.(6.62±1.44)d,and there were statistical differences(P<0.05).Logistic regression analysis showed that nutrition risk,inhalation anesthesia,stress hyperglycemia and senile weakness were independent factors of urinary infection after radical cystectomy in elderly patients with bladder cancer(P<0.05).Conclusions Urinary infection after radical cystectomy in the elderly patients with bladder cancer is closely related to nutritional risk,inhalation anesthesia,stress hyperglycemia and senile weakness.Attention to the above factors and symptomatic intervention are important for prevention and treatment of urinary infection.

关 键 词：膀胱肿瘤 老年人 根治性膀胱切除术 泌尿系感染 影响因素 

分 类 号：R737.14[医药卫生—肿瘤]