摘要
目的探讨体质指数（bodymassindex，BMI）对腹腔镜下和开放式根治性前列腺切除术的影响。方法回顾性分析2012年1月至2013年5月收治的226例行根治性前列腺切除术患者的临床资料。行腹腔镜手术患者106例，年龄（66．5±0．7）岁，身高（167．7±0．5）cm，体质量（66．8±0．9）kg，其中非肥胖组（BMI〈25kg／m2）76例（71．7％），肥胖组（BMI≥25kg／m2）30例（28．3％）；开放手术患者120例，年龄（65．8±0．7）岁，身高（168．1±0．5）cm，体质量（66．5±0馏）kg，其中非肥胖组84例（70．0％），肥胖组36例（30．O％）。分别比较两种手术方式下非肥胖组与肥胖组的手术时间、术中出血量、手术前后血红蛋白（Hb）差值、术后Gleason评分、术后留置导尿时间等情况。结果腹腔镜手术患者中非肥胖组和肥胖组的手术时间分别为（169．4±37．8）min和（188．5±42．3）min，手术前后血Hb差值分别为（-22．8±11．0）g／L和（-30．9±15．9）g／L，术中出血量分别为（115．9±68．9）ml和（178．3±126．4）ml，两组比较差异均有统计学意义（P〈0．05）；术后留置导尿时间及术后Gleason评分比较差异无统计学意义（P〉0．05）。开放手术患者中非肥胖组和肥胖组术中出血量分别为（413．7±289．4）ml和（594．4±534．9）m1，手术前后血Hh差值分别为（-27．2±13．3）g／L和（-34．9±15-8）g／L，两组间比较差异有统计学意义（P〈O．05）；术后留置导尿时间、手术时间、术后Gleason评分等比较差异均无统计学意义（P〉0．05）。结论开放式根治性前列腺切除术的肥胖患者较非肥胖患者的术中失血更多。腹腔镜下根治性前列腺切除术的肥胖患者较非肥胖患者的术中失血更多，手术时间更长。
Objective To investigate the effect of body mass index （BMI） on laparoscopy and the open radical prostatectomy. Methods A retrospective analysis of 226 cases of radical prostatectomy from 2012 January to 2013 May was performed. 106 patients underwent laparoscopie surgery, with aged 66.5±0.7, height （167.7±0.5） cm, weight （66.8±0.9） kg; 120 patients underwent open surgery, with aged （65.8± 0.7） year, height （168.1±0.5） cm ,weight （66.5±0.8） kg. Non-obese （BMI 〈25 kg/m2） and obese （BMI ≥ 25 kg/m2） were divided in each group. The preoperative serum PSA level, the operation time, the blood loss during operation, the preoperative and postoperative hemoglobin, Gleason score, and the postoperative indwelling catheter time were compared between non-obese group and obese group. In the laparoseopie sur- gery group including 76 non-obese cases （71.7%） and 30 obese cases （28.3%） , no difference showed in PSA values and age before operation between the two sub-groups. In the open surgery group, including 84 non-obese cases （ 70.0% ） and 36 obese cases （ 30.0% ） , no statistical difference of preoperative PSA values and age showed in the two sub-groups. Results In the laparoscopic group, the operation time is （non- obese 169.4±37.8 rain and obese 188.5±42.3 rain）, and the blood Hb decrease（non-obese -22.8±11.0 g/L, obese -30.9± 15.9 g/L） and the blood loss （ non-obese 115.9±68.9 ml, obese 178.3±126.4 ml） showed significant difference in the two sub-groups （P 〈 0.05 ）. The two sub-groups showed no statisticaldifference in postoperative indwelling catheter time and Gleason score （P〉0.05）. In the open surgery group, the intraoperative hemorrhage （non-obese 413.7±289.4 inl, obese 594.4±534.9 ml） and the hemoglobin de- crease （ non-obese -27.2± 13.3 g/L, obese -34.9± 15.8 g/L） showed significant difference （P〈0.05）. The two sub-groups showed no significant difference in the preoperative hemoglobin, postoperative indwelling catheter time, Gleason score and operation time （P〉0.05）. Conclusions For the patients who underwent prostatectomy, no matter by laparoscopic or open surgery, the blood loss was greater in obese subgroup than non-obese subgroup, and the operation time was much longer in obese group than non-obese group.
出处
《中华泌尿外科杂志》
CAS
CSCD
北大核心
2013年第12期897-900,共4页
Chinese Journal of Urology
基金
国家临床重点专科建设项目资助（81372773）
