膀胱癌膀胱全切除术后早期并发症的相关影响因素研究
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摘要
目的探讨膀胱癌膀胱全切除术后早期并发症发生的相关因素。方法收集200例膀胱癌患者的手术资料和术后3个月的随访资料,包括手术时间、术中出血量、术中输血量、术后住院时间等。根据改良的Clavien分级系统对膀胱癌患者术后早期并发症进行分级。分析膀胱癌患者术后早期并发症发生的影响因素。结果 200例膀胱癌患者中,124例患者术后出现早期并发症。有并发症膀胱癌患者和无并发症膀胱癌患者的年龄、糖尿病史、美国麻醉医师协会(ASA)分级、入院症状、尿流改道方式、术后住院时间比较,差异均有统计学意义(P﹤0.05);多因素分析结果显示:年龄、糖尿病史、入院症状、术后住院时间、ASA分级为膀胱癌患者术后早期并发症发生的独立影响因素。结论膀胱癌患者膀胱全切除术后早期并发症的发生率较高,年龄较大、有糖尿病史、ASA分级高、有入院症状、术后住院时间长的膀胱癌患者术后早期并发症的发生风险较高,因此要加强对该部分人群的重点关注和预防控制。
Objective To explore the related factors of early complications after radical cystectomy for bladder cancer. Method The surgical data and follow-up data in 3 months after surgery were collected from 200 patients with bladder cancer, including operative time, intraoperative blood loss, volume of intraoperative blood transfusion, postoperative hospital stay and other information. The postoperative complications were graded according to modified Clavien classification system. The factors influencing the occurrence of early postoperative complications were analyzed. Result Among the 200 cases of bladder cancer, 124 patients developed early postoperative complications. The age, history of diabetes, American Association of Anesthesiologists(ASA) classification, symptoms when admitted to hospital, urine flow changes, and postoperative hospitalization were significantly different among patients with bladder cancer complications and patients without bladder cancer complications; multivariate analysis demonstrated that, age, history of diabetes, symptoms when admitted to hospital, postoperative hospital stay, ASA classification of bladder cancer were independent influencing factors of the early occurrence of postoperative complications. Conclusion Radical cystectomy for bladder cancer patients may come along with higher incidence of early complications, to sum up, higher age, comorbidity of diabetes,higher ASA classification, presence of symptoms, longer postoperative hospital stay when admitted to hospital are associated with increased risk of developing early postoperative complications, indicating that people with these conditions shall be closely monitored, and preventive measures be strengthened.
Objective To explore the related factors of early complications after radical cystectomy for bladder cancer. Method The surgical data and follow-up data in 3 months after surgery were collected from 200 patients with bladder cancer, including operative time, intraoperative blood loss, volume of intraoperative blood transfusion, postoperative hospital stay and other information. The postoperative complications were graded according to modified Clavien classification system. The factors influencing the occurrence of early postoperative complications were analyzed. Result Among the 200 cases of bladder cancer, 124 patients developed early postoperative complications. The age, history of diabetes, American Association of Anesthesiologists(ASA) classification, symptoms when admitted to hospital, urine flow changes, and postoperative hospitalization were significantly different among patients with bladder cancer complications and patients without bladder cancer complications; multivariate analysis demonstrated that, age, history of diabetes, symptoms when admitted to hospital, postoperative hospital stay, ASA classification of bladder cancer were independent influencing factors of the early occurrence of postoperative complications. Conclusion Radical cystectomy for bladder cancer patients may come along with higher incidence of early complications, to sum up, higher age, comorbidity of diabetes,higher ASA classification, presence of symptoms, longer postoperative hospital stay when admitted to hospital are associated with increased risk of developing early postoperative complications, indicating that people with these conditions shall be closely monitored, and preventive measures be strengthened.
引文
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[10]黄应龙,王剑松,于跃平,等.膀胱全切原位尿流改道术后早期并发症及危险因素分析[J].广东医学,2017,38(3):378-382.
[11]杨柏帅,叶定伟,沈益君,等.年龄对膀胱癌根治术的影响及预后分析[J].中国癌症杂志,2009,19(11):851-855.
[12]张龙波.全膀胱切除尿路改道术后早期并发症及危险因素研究[J].临床医学研究与实践,2017,2(1):3-5.
[13]余绍龙,侯国良,周芳坚,等.改良全膀胱切除术治疗浸润性膀胱癌188例疗效总结[J].癌症,2009,28(5):500-505.
[2]温登瑰,张思维,郑荣寿,等.中国2009年膀胱癌发病和死亡资料分析[J].中国肿瘤,2013,22(7):521-527.
[3]Babjuk M,Burger M,Zigeuner R,et al.EAU guidelines on non-muscle-invasive urothelial carcinoma of the bladder:update 2013[J].European Urology,2013,64(4):639-653.
[4]Mamoulakis C,Efthimiou I,Kazoulis S,et al.The modified Clavien classification system:a standardized platform for reporting complications in transurethral resection of the prostate[J].World J Urol,2011,29(2):205-210.
[5]季名飞.全膀胱切除尿路重建术后早期并发症及危险因素探讨[D].大连:大连医科大学,2014.
[6]杨林,吴小候,陈在贤,等.全膀胱切除137例临床分析[J]重庆医学,2012,41(2):129-130.
[7]许传亮,曾蜀雄,张振声,等.腹腔镜下全膀胱切除术疗效及早期并发症的临床分析[J].中华泌尿外科杂志,201435(7):539-542.
[8]高峰,赵晓昆.全膀胱切除术后不同尿流改道术式的疗效比较[J].现代中西医结合杂志,2014,23(22):2441-2442;2443.
[9]周晓波,廖锦先.全膀胱切除术不同尿流改道术式在膀胱癌治疗中的应用价值[J].广州医科大学学报,2015,43(4):79-82.
[10]黄应龙,王剑松,于跃平,等.膀胱全切原位尿流改道术后早期并发症及危险因素分析[J].广东医学,2017,38(3):378-382.
[11]杨柏帅,叶定伟,沈益君,等.年龄对膀胱癌根治术的影响及预后分析[J].中国癌症杂志,2009,19(11):851-855.
[12]张龙波.全膀胱切除尿路改道术后早期并发症及危险因素研究[J].临床医学研究与实践,2017,2(1):3-5.
[13]余绍龙,侯国良,周芳坚,等.改良全膀胱切除术治疗浸润性膀胱癌188例疗效总结[J].癌症,2009,28(5):500-505.