膀胱输尿管反流患者膀胱输尿管吻合术后再返流发生率及危险因素分析

Analysis of the incidence of recanalization and related risk factors in patients with vesicoureteral reflux after vesicoureteral anastomosis

目的观察膀胱输尿管返流(VUR)患者膀胱输尿管吻合术后再返流发生率及危险因素分析。方法选取2015年8月至2019年1月于大连市瓦房店第三医院收治的VUR患者375例,均接受膀胱输尿管吻合术治疗,观察手术成功率及各项手术指标;比较手术成功患者和再返流患者的性别、身高、体重、侧别、高级别返流、返流发生时期、输尿管直径、肾损害,分析再返流的危险因素。结果375例患者单侧平均手术时间(142.34±12.64)min,双侧平均手术时间(251.31±10.34)min,平均住院时间(5.7±0.8)d。手术成功330例(88.0%),再返流45例(12.0%)。手术成功组和再返流组性别、高级别返流、返流发生时期、输尿管直径、肾损害差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,高级别返流和肾损害是VUR患者术后再返流的危险因素。结论膀胱输尿管吻合术能够有效治疗VUR,高级别返流和肾损害是VUR患者膀胱输尿管吻合术后再返流的危险因素。

Objective To observe the incidence of recanalization of vesicoureteral reflux(VUR)patients after vesicoureteral anastomosis and analyze related factors.Methods A total of 375 VUR patients treated with vesicoureteral anastomosis in our hospital from August 2015 to January 2019 were selected as the research objects.The surgical success rate and various surgical indicators of all patients were observed.And some risk factors,such as gender,height,weight,side and high-level reflux were selected for analysis.Results The average operation time on one side was(142.34±12.64)min,while that on both sides was(251.31±14.34)min.The average hospital stay was(4.7±0.83)days.There were 330 patients with successful operations,with a success rate of 88%.After univariate analysis,it was found that gender,high-level reflux,period of reflux,ureter diameter,and kidney damage were risk factors for VUR,among which,high-grade reflux and renal damage were independent risk factors for vesicoureteral recanalization.Conclusion Cystoureteral anastomosis can effectively treat VUR.The high-level reflux and renal damage are independent risk factors for vesicoureteral recanalization.