根治性膀胱切除术后30 d内并发症的发生情况及危险因素分析

夏照明; 土应果; 郭民; 杨建昌; 李智斌; 李元; 杨旺秋

doi:10.13201/j.issn.1001-1420.2021.09.007

根治性膀胱切除术后30 d内并发症的发生情况及危险因素分析

- 大理白族自治州人民医院泌尿外科(云南大理, 671000)

详细信息

通讯作者: 土应果,E-mail:tuyinguo@126.com

中图分类号: R737.14

收稿日期: 2021-02-22

Incidence and risk factors of complications within 30 days after radical cystectomy

- Department of Urology,Dali Bai Autonomous Prefecture People's HospitalDali, Yunnan, 671000, China

More Information

Corresponding author: TU Yingguo, E-mail: tuyinguo@126.com

Received Date: 22 February 2021

摘要

摘要: 目的:分析根治性膀胱切除术(RC)术后30 d内出现并发症的危险因素。方法:回顾性分析2008年8月—2020年8月大理白族自治州人民医院泌尿外科行根治性膀胱切除的172例患者的临床资料,归纳根治性膀胱全切术后30 d内并发症发生的情况,并对RC+乙状结肠原位新膀胱术出现并发症的危险因素进行logistic回归分析。结果:172例患者中,男155例,女17例,平均年龄(67.54±5.25)岁,其中有85例出现围手术期并发症,并发症发生率49.4%,前4位并发症为术后感染、术中出血、切口并发症、新膀胱瘘。单因素logistic分析术前合并糖尿病、术前合并肾功能不全、术后白蛋白水平、术中出血量多及术后血红蛋白水平与并发症的发生率有关,多因素logistic分析显示术前合并糖尿病(OR=5.495,95%CI:1.168~25.855,P=0.031)、术前合并肾功能不全(OR=9.467,95%CI:1.348~66.483,P=0.024)、术后白蛋白水平低(OR=0.489,95%CI:0.268~0.893,P=0.020)、术中出血量多(OR=2.373,95%CI:1.224~4.599,P=0.010)、术后血红蛋白低(OR=0.502,95%CI:0.287~0.877,P=0.016)是RC+乙状结肠原位新膀胱患者围手术期并发症的独立危险因素。结论:RC术后并发症发生率较高,合并糖尿病、肾功能不全、术后低白蛋白、术中出血量多及术后血红蛋白低是出现并发症的高危因素,控制好血糖、改善肾功能、术后积极补充白蛋白、减少术中出血、术后补充血红蛋白可以减少术后并发症的发生。
- 膀胱癌 /
- 根治性膀胱切除术 /
- 并发症
Abstract: Objective: To analyze the risk factors for complications within 30 days after radical cystectomy(RC).Methods: The clinical data of 172 patients who underwent RC in the Department of Urology, Dali People's Hospital from August 2008 to August 2020 were retrospectively analyzed. The incidence of complications within 30 days after radical bladder resection was summarized, and the risk factors for complications after RC were analyzed by logistic regression.Results: Among the 172 patients, there were 155 males and 17 females, with an average age of(67.54±5.25) years. Among them, 85 had perioperative complications, and the incidence of complications was 49.4%. The top four complications were postoperative infection, intraoperative bleeding, incision complications and new bladder fistula. In univariate analysis, preoperative diabetes mellitus, preoperative renal insufficiency, postoperative albumin level, high intraoperative blood loss and postoperative hemoglobin level were associated with the incidence of complications. In multivariate analysis, diabetes mellitus(OR=5.495, 95%CI: 1.168-25.855, P=0.031) renal insufficiency(OR=9.467, 95%CI: 1.348-66.483, P=0.024), low albumin level(OR=0.489, 95%CI: 0.268-0.893, P=0.020) and high intraoperative blood loss(OR=2.373, 95%CI: 1.224-4.599, P=0.010), low postoperative hemoglobin(OR=0.502, 95%CI: 0.287-0.877, P=0.016) were independent risk factors for perioperative complications in RC patients.Conclusion: The incidence of complications after RC is high, and diabetes mellitus, renal insufficiency, postoperative low albumin, high intraoperative blood loss and low postoperative hemoglobin are the high risk factors for complications. Good control of blood glucose, improvement of renal function, active postoperative albumin supplementation and reduced intraoperative bleeding and postoperative hemoglobin supplementation can reduce the incidence of postoperative complications.
- bladder cancer /
- radical cystectomy /
- complications

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