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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 analyze the Accordion classification of complications of urinary tract surgery in children undergoing laparoscopic transabdominal approach. To explore the risk factors influencing postoperative complications and to provide preventive measures. Methods: A retrospective analysis of 1 035 patients undergoing laparoscopic transurethral urography in a single center (5 years) was performed using Accordion classification. The frequency of complications and the risk factors influencing complication were analyzed by univariate and multivariate analysis . Results: A total of 1 035 cases of complications occurred in 181 cases. All children with complications were discharged after being treated correctly and correctly. After univariate and multivariate analysis, the proficiency of the surgeon, the intraoperative management strategy, the age of the children, the operation time, and the severity of the disease were all independent risk factors for postoperative complications (P <0.05). Conclusion: The full understanding of the common complications of pediatric urology surgery, improve surgical skills, correct prevention and treatment of complications, to avoid serious complications, is conducive to the recovery of children.