输尿管膀胱再植术后再梗阻的危险因素研究
Risk factors of re-obstruction after extravesical ureteral reimplantation
周培杰 1骆永博 2杜凯旋 2任梦达 2曾佑苗 2顾朝辉2
作者信息
- 1. 郑州大学第一附属医院泌尿外科,郑州 450052
- 2. 郑州大学第一附属医院泌尿外科,郑州 450052;郑州大学第一附属医院日间手术中心病房,郑州 450052
- 折叠
摘要
目的 探讨输尿管膀胱再植术后再梗阻的独立危险因素.方法 回顾性分析2015年5月至2020年4月郑州大学第一附属医院泌尿外科行输尿管膀胱再植术的235例患者的临床资料及术后随访资料.其中男126例,女109例,年龄(24.71±8.93)岁,根据术后24个月内是否出现再梗阻分为发生再梗阻组(21例)和未发生再梗阻组(214例).通过单因素和多因素Logistic回归分析两组的病例资料.结果 单因素分析表明,腹腔镜手术组再梗阻发生率高于机器人辅助腹腔镜手术组[12.41％(18/145)比3.33％(3/90),x2=5.63,P＜0.05].发生再梗阻组术中出血量高于未发生再梗阻组[(297.60±136.00)ml 比(232.80±99.28)ml,f=2.76,P＜0.01].发生再梗阻组术后引流量高于未发生再梗阻组[(854.50±198.30)ml比(560.40±133.70)ml,t=9.26,P＜0.01].发生再梗阻组术后感染率高于未发生再梗阻组[61.90％(13/21)比5.14％(11/214),x2=67.20,P＜0.01].发生再梗阻组术后肉眼血尿持续时间长于未发生再梗阻组[(11.05±2.22)d比(9.43±1.76)d,t=3.91,P＜0.01].两组的年龄、性别、BMI、术前输尿管扩张直径和手术时间比较,差异无统计学意义.多因素分析表明,术后引流量[比值比(OR)=1.011,95％置信区间(CI):1.005～1.018,P＜0.01)和术后肉眼血尿持续时间(OR=1.708,95％CI:1.195～2.678,P＜0.01)为输尿管膀胱再植术后发生再梗阻的独立危险因素.结论 术后引流量和术后肉眼血尿持续时间为输尿管膀胱再植术后发生再梗阻的独立危险因素.
Abstract
Objective To study the independent risk factors of re-obstruction after ureteral bladder replantation.Methods The clinical data and postoperative follow-up data of 235 patients who underwent ureteral bladder replantation in the Department of Urology of the First Affiliated Hospital of Zhengzhou University from May 2015 to April 2020 were analyzed retrospectively.There were 126 males and 109 fe-males,aged(24.71±8.93)years.According to the occurrence of re-obstruction wwithin 24 months after operation,the patients were divided into two groups:re-obstruction group(n=21)and non-re-obstruction group(n=214).The case data of the two groups were analyzed by univariate and multivariate logistic re-gression.Results Univariate analysis showed that the incidence of re-obstruction in the laparoscopic sur-gery group was higher than that in the robot-assisted laparoscopic surgery group[12.41％(18/145)vs.3.33％(3/90),x2=5.63,P＜0.05].The amount of intraoperative blood loss in the recurrent obstruc-tion group was greater than that in the non-recurrent obstruction group[(297.60±136.00)ml vs.(232.80±99.28)ml,t=2.76,P＜0.01].The postoperative drainage volume in the recurrent obstruc-tion group was greater than that in the non-recurrent obstruction group[(854.50±198.30)ml vs.(560.40±133.70)ml,P＜0.01].The postoperative infection rate in the re-obstruction group was higher than that in the non-re-obstruction group[61.90％(13/21)vs.5.14％(11/214),x2=67.20,P＜0.01].The duration of gross hematuria in the recurrent obstruction group was longer than that in the non-recurrent obstruction group[(11.05±2.22)days vs.(9.43±1.76)days,t=3.91,P＜0.01].There was no significant difference in age,sex,BMI,preoperative ureteral dilatation diameter and operation time between the two groups.Multivariate analysis showed that postoperative drainage[odds ratio(OR)=1.005,95％confidence interval(CI):1.005～1.018,P＜0.01)and postoperative duration of gross hematuria(OR=1.708,95％CI:1.195～2.678,P＜0.01)were independent risk factors for re-obstruc-tion after ureteral bladder replantation.Conclusion Postoperative drainage and postoperative duration of gross hematuria are independent risk factors for re-obstruction after ureteral bladder replantation.
关键词
输尿管膀胱再植术/再梗阻/危险因素Key words
Extravesical ureteral reimplantation/Re-obstruction/Risk factor引用本文复制引用
基金项目
河南省专业学位研究生精品教学案例项目(YJS2023AL013)
郑州大学教育教学改革研究与实践重点项目(2022ZZUJG082)
出版年
2024
NETL
NSTL
万方数据