单中心小儿泌尿系腹腔镜手术的并发症分析及防治

Common postoperative complications and risk factors in the pediatric population treated with laparoscopic urological procedures at a single center

目的:分析腹腔镜经腹入路小儿泌尿系手术并发症的Accordion分级;探讨影响术后并发症发生的危险因素并提出预防措施。方法:回顾分析单中心(5年间)1 035例腹腔镜经腹入路泌尿系手术的资料,采用Accordion分级;通过单因素和多因素分析并发症出现的频率及分析影响并发症发生的危险因素。结果:1 035例手术出现并发症181例,所有并发症患儿积极正确处理后均痊愈出院。经过单因素及多因素分析,手术者熟练程度、术中的处理策略、患儿年龄、手术时间、疾病的严重程度都是影响术后发生并发症的独立危险因素(P<0.05)。结论:充分认识腹腔镜小儿泌尿系手术的常见并发症,提高手术操作技巧,正确预防和处理并发症,避免严重并发症,有利于患儿的恢复。

Objective：To investigate the common postoperative complications and risk factors in the pediatric population treated with laparoscopic urological procedures.Method：The clinical data of 1 035 patients treated with laparoscopic urological procedures during last five years were collected to analyze the common postoperative complications through the Accordion Grade system and establish a logistic regression model to predict these complications.Result：One hundred and eighty-one patients among 1 035 population with common postoperative complications recovered after appropriate treatments.Univariate and multivariate logistic regression analysis indicated that the technique and skill of the operator,surgery tactics,children＇s age,operation time and severity of disease were independent risk factors of complications related to the procedure.Conclusion：Fully understanding the common complications of laparoscopic urologic surgery in children,improving the operation skills and appropriate treatment of complications can avoid the occurrence of serious consequences,which is conducive to the recovery of the children.