改良Clavien并发症严重程度分级系统在膀胱癌根治术早期并发症中的应用

摘要

目的:探讨改良Clavien并发症严重程度分级系统在膀胱癌根治术早期并发症中的应用.方法:比较分析泌尿外科2013年10月~2016年10月间104例进行过膀胱癌根治术的膀胱癌患者的临床资料,并依据改良Clavien分级系统将上述患者术后早期并发症进行分级评估.结果:共有17例患者在手术后发生早期并发症,其中9例患者为1级并发症,4例患者为2级并发症,2例患者为3级并发症,1例患者为4级并发症,1例患者为5级并发症.膀胱癌根治术后早期并发症发生率高于以往报道,影响术后早期并发症发生的危险因子包括美国医师协会麻醉(ASA)分级以及合并基础疾病;影响高等级术后早期并发症的危险因子包括患者总住院时间较长、术前低白蛋白血症以及存在术中输血情况.结论:ASA分级以及合并基础疾病影响术后早期并发症发生,患者总住院时间较长、术前低白蛋白血症以及存在术中输血情况影响高等级术后早期并发症.%Objective:To investigate the application of modified Clavien complication severity classification system in the early complications of radical resection of bladder cancer.Methods:The clinical data of 104 patients with bladder cancer who underwent radical cystectomy between October 2013 and October 2016 in Department of urology were analyzed and compared.The early postoperative complications were evaluated according to the modified Clavien classification system.Results:A total of 17 patients developed early complications after surgery.Among them,9 patients were grade 1 complications,4 patients were grade 2 complications,2 patients were grade 3 complications,1 patient was grade 4 complications,and 1 patient was grade 5 complications.The incidence of early complications after radical cystectomy is higher than that reported previously.The risk factors for early postoperative complications include ASA classification and associated with underlying diseases.The risk factors for early postoperative complications include longer hospital stays,preoperative hypoalbuminemia,and presence of intraoperative blood transfusions.Conclusions:ASA classification and consolidation of underlying diseases affect early postoperative complications.The total length of hospital stays,the presence of preoperative hypoalbuminemia and the presence of intraoperative blood transfusions affect the early postoperative complications.