全膀胱切除尿路改道术后早期并发症及危险因素研究

张龙波

（重庆市万州区人民医院泌尿外科，重庆，404100）

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摘要：

目的 探讨研究全膀胱切除尿路改道术后早期并发症的发生情况及相关的危险因素。方法 回顾性分析2012 年6月至 2014年3月我院泌尿外科行膀胱切除尿路改道术的47例膀胱癌患者病例资料，分析早期术后并发症（90 d 内）的发生情况， 并根据有无并发症进行组间危险因素单因素分析，同时对筛选出的相关危险因素进行多因素logistic 回归分析。结果47例中病例中出现并发症的病例数为37 例（78.7%），最常见的早期并发症依次是泌尿系统并发症（ 18  例，38.8%）、胃肠道并发症（11 例，23.4%）和切口并发症（9 例，19.1%）。单因素分析显示与总并发症有统计学意义的危险因素有吸烟史、平均动脉血压、 术前肌酐水平和手术时间；对上述危险因素整合后经多因素logistic 回归显示：术前肌酐水平和手术时间是引起术后并发症 的重要风险因素。结论 根治性膀胱切除术后的短期并发症的发生率较高，术前肌酐水平和手术时间是引起术后并发症的重要风险因。因此，有针对性的对危险因素进行防控是减少病人术后的并发症的重要途径。 

关键词：膀胱肿瘤；全膀胱切除术；早期并发症；危险因素

中图分类号：R737.14文献标志码：A文章编号：2096-1413(2017)01-0003-03

The study of early complications and related risk factors after radical cystectomy and urethra reconstruction
ZHANG Long-bo
(Urology Surgery Department, Chongqing Municipality District People s Hospital, Chongqing 404100, China)

ABSTRACT: Objective To discuss early complications after radical cystectomy and urethra reconstruction and the associated risk factors. Methods The clinical data of 47 patients with carcinoma of urinary bladder who underwent radical cystectomy and urethra reconstruction in our hospital were retrospectively analyzed. Early postoperative complications (with 90 d) were analyzed, and the univariate analysis of the risk factors was performed according to the presence or absence of complications. Meanwhile, multivariate logistic regression analysis was used to analyze the related risk factors. Results Of the 47 objects, 37 (78.7%) had complications. The most common early complications were urinary system complications (18 cases, 38.3%), gastrointestinal complications (11 cases, 23.4%) and incision complications (9 cases, 19.1%). Univariate analysis showed smoking history, mean arterial blood pressure, preoperative creatinine level, and operative time had statistically significant with total complications. Multivariate logistic regression showed that preoperative creatinine level and operation time were the important risk factors for postoperative complications. Conclusion The incidence of short-term complications after radical cystectomy is higher, and preoperative creatinine and operation time are important risk factors for postoperative complications. Therefore, targeted prevention and control of risk factors is an important way to reduce postoperative complications of the patient.
KEYWORDS: carcinoma of urinary bladder; radical cystectomy; early complications; risk factors

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