根治性膀胱切除术后早期并发症及危险因素分析

摘要

Objective:To investigate the risk factors of early postoperative complications (90 days) after radical cystectomy (RC).Methods:We collected clinical data of 185 patients who had undergone radical cystectomy (RC) due to bladder cancer in the urology department of our hospital from January 2013 to January 2016,we followed-up them 90 days after operation,and analysis the associated specific risk factors of early-term complications by using the single factor x2 test and the Logistics regression analysis.Results:Among 185 cases of bladder cancer patients that had received radical operation,74 patients(40.0％) had different early complications in the 90 days after surgery.The common complications were intestinal obstruction,urinary tract infection and incision complications.From the regression analysis we find that the age (≥65 years old),obesity (BMI ≥25 kg/m2),intraoperative blood transfusion,operative method,operative time,diabetes is the risk factors of early complications after radical cystectomy.Conclusion:The incidence of early postoperative complications after radical cystectomy was higher,the intestinal obstruction,urinary tract infection,incision complications are more common.And correct perioperative management and adequate preoperative preparation are the key to reduce the early complications after radical operation of bladder cancer.%目的:探讨根治性膀胱切除术(RC)后早期并发症(术后90 d内)及其相关的危险因素.方法:收集我院泌尿外科2013年1月至2016年1月期间共185例因膀胱癌行根治性膀胱切除术(RC)的临床资料,术后90天内对患者随访,并应用X2检验和Logistic回归分析术后常见早期并发症的危险因素.结果:术后90天内185位患者中有74位(40.0％)出现了不同的早期并发症,常见并发症依次为肠梗阻、泌尿系感染、切口方面并发症.在回归分析中发现年龄(≥65岁)、肥胖(BMI≥25 kg/m2)、术中输血、手术方式、手术时间、糖尿病是发生RC术后早期并发症的危险因素.结论:根治性膀胱切除术术后早期并发症发生率较高,其中肠梗阻、泌尿系感染、切口方面并发症较常见,正确的围手术期处理及充足的术前准备是降低膀胱癌根治术术后早期并发症的关键.