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目的:分析影响后腹腔镜下肾切除术治疗无功能肾结核中转开放的主要风险因素。方法:回顾性分析144例同一术者完成的后腹腔镜治疗无功能肾结核的临床资料。对患者的性别、年龄、体质指数(body mass index,BMI)、伴随疾病(高血压、糖尿病)、肾脏情况(患肾位置、患肾大小、是否钙化、患肾周围轻度渗出)、对侧肾脏积水情况、术前抗结核时间及术者经验等相关因素进行单因素和多因素logistic回归分析。结果:144例患者中,23例中转开放手术,余121例均成功。在单因素分析中,BMI(P=0.023)、合并糖尿病(P=0.003)、合并高血压(P=0.011)、患肾体积增大(P=0.032)是影响后腹腔镜治疗无功能肾结核中转开放的主要因素。多因素Logistic回归分析中,BMI≥30 kg/m~2、糖尿病、高血压、患肾体积增大显著增加了后腹腔镜治疗无功能肾结核中转开放风险。结论:BMI≥30 kg/m~2、合并糖尿病、合并高血压、患肾体积增大可显著增加后腹腔镜治疗无功能肾结核中转开放的风险。
OBJECTIVE: To analyze the main risk factors influencing laparoscopic nephrectomy in the treatment of non-functional renal tuberculosis. Methods: Retrospective analysis of 144 cases of the same operation completed laparoscopic treatment of non-functional renal tuberculosis clinical data. The patient’s gender, age, body mass index (BMI), concomitant diseases (hypertension, diabetes), kidney conditions (kidney position, kidney size, calcification, mild peri-renal exudation) Side kidney hydronephrosis, preoperative anti-TB time and the experience of the surgeon and other related factors were analyzed by multivariate logistic regression analysis. Results: Among the 144 patients, 23 cases were transferred to open surgery and 121 cases were successful. In univariate analysis, BMI (P = 0.023), diabetes mellitus (P = 0.003), hypertension with hypertension (P = 0.011) and increased renal volume (P = 0.032) were associated with retroperitoneal laparoscopic treatment of non-functional renal tuberculosis The main factor in the transfer of open. Multivariate logistic regression analysis showed that BMI≥30 kg / m ~ 2, diabetes mellitus, hypertension and increased renal volume significantly increased the risk of postoperative laparoscopic conversion of nonfunctional renal tuberculosis. Conclusion: BMI≥30 kg / m ~ 2, combined with diabetes mellitus, with hypertension, increased renal volume can significantly increase the risk of laparoscopic conversion of nonfunctional renal tuberculosis.