| 摘要: |
| ［摘要］目的 应用改良型Clavien手术并发症分级系统分析微通道经皮肾镜取石术（mPNL）术后并发症，探讨诱发微通道经皮肾镜取石术后并发症的危险因素．方法 应用改良型Clavien手术并发症分级系统分析昆明医科大学第二附属医院自1999年9月至2010年12月间4 533例微通道经皮肾镜取石术的并发症与5个临床相关因素进行相关性分析．结果 88例（1.94％）发生术后并发症，主要并发症为出血69例（0.24％）、结肠损伤5例（0.11%）、感染性休克3例（0.06%）液体吸收综合征5例（0.11%）胸腔积液6例（0.13％）．按改良型Clavien手术并发症分级I级11例（0.24％）、11级71例（1.56％）、Ⅲa级6例（0.13％）、Ⅲ b级0例、Ⅳa级0例、Ⅳb级0例、V级0例．发生11级、Ⅲ级并发症的患者的平均住院时间较I级和无并发症的患者明显延长．Logistic多因素回归分析结果显示手术时间（OR=1.46）、ASA评分（OR=2.49）、合并心血管或糖尿病疾病（OR=1.67）、结石负荷（OR=1.34）、尿培养阳性（OR=0.97）．结论 改良型Clavien手术并发症分级系统对mPNL术后并发症具有客观性强、标准化、学习曲线短等优点． |
| 关键词: ［关键词］ 微通道 经皮肾镜 并发症 Clavien分级 改良型 |
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| 基金项目:［基金项目］云南省科技厅社会发展专项基金资助项目（2010CA009） |
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| The Analysis of Using Modified Clavien Classification of Surgical Complications in Postoperative Complications of Mini-Percutaneous Nephrolithotomy |
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LI Pei
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（Dept．of Urology Ward 3，The 2nd Affiliated Hospital of Kunming Medical University，Kunming Yunnan 650101，China）
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| Abstract: |
| ［Abstract］Objective To discuss risk factors for postoperative complications after Mini-percutaneous nephrolithotomy（mPNL）using modified Clavien classification of surgical complications. Methods From September 1999 to December 2010，4533 patients having complications after mPNL were analyzed with five related clinical factors using the modified Clavien classification of surgical complications in the Second Affiliated Hospital of Kunming Medical University. Results Among 88 cases having complications（1.94%），69 had hemorrhage （0.24%），5 had colon injury（0.11%）， 3 had septic shock（0.06%），5 had liquid absorption syndrome （0.11%），6 had pleural effusion（0.13%）. According to the modified Clavien classification，11 cases were clustered into Class I （0.24%），71 cases into Class II（1.56%），6 cases into Class Ⅲa （0.13%）and no cases was classified in Class Ⅲb，Ⅳa， Ⅳb and V. For patients having complications of Class II and III， the average hospital stay was significantly longer than those having either Class I or no complications. Multiple logistic regression analysis showed that five factors were associated with postoperative complications，including operation time（OR=1.46）， ASA score（O =2.49），having cardiovascular disease or diabetes at the same time（OR=1.67）， stone load （OR=1.34）and positive urine culture（OR=0.97）. Conclusion Using modified Clavien classification of surgical complications in the analysis of mPNL was standard， objective， applicable and recommended. |
| Key words: ［Key words］Mini-track Percutaneous nephrolithotomy Complication Clavien classification system The modified type |