摘要
目的探讨膀胱根治性全切Bricker回肠膀胱术后发生脓毒血症的危险因素。方法回顾性分析2009-07/2016-12月解放军武汉总医院完成123例Bricker回肠膀胱术,统计所有患者临床参数。对术后短期或反复发生脓毒血症患者及无脓毒血患者的临床参数行统计学分析,包括性别、年龄、是否合并糖尿病、既往经尿道膀胱肿瘤电切(transurethral resection of bladder tumour,TURBT)手术史、术后血红蛋白、血清白蛋白水平,体质量指数(body mass index,BMI)、手术时间、术中出血量、术后病理类型、发病原因等。结果随访有21例术后患者近期或远期间断出现脓毒血症症状。术后发生脓毒血症患者血红蛋白水平偏低,女性患者发病率高,发病原因以肾盂肾炎最多见;多因素回归分析显示,女性、糖尿病、肾盂肾炎、肾积水、呼吸道感染、血红蛋白水平等因素与脓毒血症的发生有相关性。结论 Bricker回肠膀胱术后需注意尿流改道后局部易感性,女性、糖尿病、术后低血红蛋白、合并肾积水、发作肾盂肾炎、呼吸道感染等均为Bricker回肠膀胱术后脓毒血症危险因素。
Objective To investigate the risk factors of sepsis after radical cystectomy with Bricker ileal conduit.Methods From July,2009 to December,2016,123 patients underwent Bricker ileal conduit in Wuhan General Hospital were retrospectively analyzed,and the clinical parameters of all patients were counted.The clinical parameters of patients with short-term or recurrent sepsis and without sepsis were statistically analyzed,including gender,age,diabetes,transurethral resection of bladder tumour（TURBT）history,postoperative hemoglobin,postoperative serum albumin,body mass index（BMI）,operation time,intraoperative blood loss,postoperative pathological type,cause of the disease,etc.Results Twenty-one patients during the follow-up showed sepsis symptoms in near-or long-term intermittently.Hemoglobin levels were lower in patients with sepsis after surgery,the incidence of female patients was higher,and the most common cause was the pyelonephritis.Multivariate regression analysis showed that the following factors associated with the occurrence of sepsis were female,diabetes,pyelonephritis,hydronephrosis,respiratory infection,hemoglobin levels,and etc.Conclusion Bricker ileal conduit should pay attention to local susceptibility after urinary diversion.Female,diabetes,hydronephrosis,pyelonephritis,respiratory infections and hemoglobin levels are all risk factors of sepsis after Bricker ileal conduit.
作者
刘伟
潘铁军
杨家荣
刘波
蒋渊
徐媛玉
涂忠
LIU Wei;PAN Tiejun;YANG Jiarong;LIU Bo;JIANG Yuan;XU Yuanyu;TU Zhong(Department of Urology,Wuhan General Hospital of Chinese People＇s Liberation Army,Wuhan Hubei 430070,China)
出处
《华南国防医学杂志》
CAS
2018年第8期532-536,共5页
Military Medical Journal of South China
