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评估患者的体重指数可能有助于预测韩国男性耻骨后根治性前列腺切除术中的失血量。

Assessing the body mass index of patients might help to predict blood loss during radical retropubic prostatectomy in Korean men.

作者信息

Chang In Ho, Byun Seok-Soo, Hong Sung Kyu, Lee Sang Eun

机构信息

Department of Urology, Seoul National University Bundang Hospital, Gumi-dong, Bundang-gu, Seongnam, Kyunggi-do, Korea 463-707.

出版信息

BJU Int. 2007 Mar;99(3):570-4. doi: 10.1111/j.1464-410X.2006.06637.x. Epub 2006 Dec 13.

Abstract

OBJECTIVE

To examine the intraoperative blood loss and patient characteristics in patients treated with radical retropubic prostatectomy (RRP), to determine the independent risk factors that predict increased blood loss and transfusion requirements in Korean men.

PATIENTS AND METHODS

We retrospectively analysed the records of 264 consecutive patients who had RRP; all medical records were reviewed for various factors before RRP, including prostate volume and body mass index (BMI), and during RRP, e.g. operative duration, estimated blood loss (EBL), calculated blood loss (CBL) and neurovascular bundle preservation. We evaluated differences in clinical characteristics and intraoperative factors in patients categorised by BMI. Multivariate logistic regression analysis was used to establish the relationship between preoperative independent variables and endpoints related to a high CBL.

RESULTS

The mean EBL was lower than the CBL (387.3 vs 716.9 mL). When the group of men was stratified by BMI, although the difference in mean EBL (P = 0.160) and transfusion rate (P = 0.511) among normal, overweight and obese categories were not statistically significant, the difference in mean CBL (P = 0.011) and operative duration (P = 0.022) was statistically significantly higher in overweight and obese men. Patients who had their neurovascular bundles preserved had no statistically differences in CBL, EBL and operative duration from those with did not. The multivariate logistic regression analysis showed that BMI was the only preoperative variable that predicted a high CBL.

CONCLUSIONS

The EBL was underestimated by the CBL, and the BMI was the only predictor before RRP of blood loss during RRP in these Korean men.

摘要

目的

研究耻骨后根治性前列腺切除术(RRP)患者的术中失血量及患者特征,以确定预测韩国男性失血量增加和输血需求的独立危险因素。

患者与方法

我们回顾性分析了264例连续接受RRP治疗的患者的记录;对RRP术前的各种因素,包括前列腺体积和体重指数(BMI),以及RRP术中的因素,如手术持续时间、估计失血量(EBL)、计算失血量(CBL)和神经血管束保留情况进行了审查。我们评估了按BMI分类的患者在临床特征和术中因素方面的差异。采用多因素逻辑回归分析来建立术前独立变量与高CBL相关终点之间的关系。

结果

平均EBL低于CBL(387.3对716.9 mL)。当按BMI对男性组进行分层时,尽管正常、超重和肥胖类别之间的平均EBL差异(P = 0.160)和输血率差异(P = 0.511)无统计学意义,但超重和肥胖男性的平均CBL差异(P = 0.011)和手术持续时间差异(P = 0.022)具有统计学意义。保留神经血管束的患者与未保留神经血管束的患者在CBL、EBL和手术持续时间方面无统计学差异。多因素逻辑回归分析显示,BMI是预测高CBL的唯一术前变量。

结论

CBL低估了EBL,BMI是这些韩国男性RRP术前预测RRP术中失血量的唯一因素。

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