膀胱全切术后影响患者生存及预后的危险因素分析

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1、授予单位代码10089学号或申请号20153248中国图书分类号R699.5HebeiMedicalUniversity硕士学位论文专业学位膀胱全切术后影响患者生存及预后的危险因素分析姓名：张航导师：张勇教授专业：外科学二级学院：河北医科大学第二医院2018年3月目录中文摘要············································································1英文摘要··········································

2、··································2英文缩写············································································4研究论文膀胱全切术后影响患者生存及预后的危险因素分析前言············································································5资料与方法···································

3、····································5结果············································································8附图············································································9附表································································

4、············16讨论············································································18结论············································································21参考文献·········································································21综述肌层浸润性膀

5、胱癌研究及治疗进展·························23致谢············································································35个人简历············································································36中文摘要膀胱全切术后影响患者生存及预后的危险因素分析摘要目的：本研究探讨膀胱根治性切除术后影响患者生存及预后的危险因素，并为患

6、者术后恢复提供理论性依据。方法：回顾性收集河北医科大学第二医院2012年9月到2017年12月的膀胱尿路上皮癌患者并于本院行膀胱根治性切除术的临床病理及随访资料并进行分析。分析因素包括患者年龄、性别、是否合并慢性疾病、手术方式、TNM分期、淋巴结是否转移、输尿管是否侵袭、尿道残端是否受累、肿瘤大小、肿瘤多灶性及术后新辅助治疗。结果：随访患者68例，其中7例患者随访信息不完善。随访资料完整的患者为61例。随访期为3-60个月。Log-rank检验进行的单因素分析显示：患者的T分期、肿瘤大小、尿流改道方式、输尿管是否侵袭

7、、尿道残端是否累及、有无淋巴结转移、术后新辅助化疗这些因素P<0.05，差异有统计学意义。Cox多因素分析结果显示：尿流改道方式、T分期、淋巴结是否转移及术后新辅助化疗对患者生存预后的影响差异有统计学意义（P<0.05）。结论：Cox比例风险模型结合Log-rank检验显示患者T分期、是否淋巴结转移及术后新辅助化疗是影响患者预后的因素。从诸多因素中选出主要因素，再进行有效地措施进行干预，从而减低患者死亡率，提高生存率。关键词：膀胱癌,膀胱全切,预后因素,Log-rank检验,Cox比例风险模型1英文摘要Analysi

8、sofRiskFactorsAffectingPatients'SurvivalandPrognosisafterRadicalCystectomyABSTRACTObject:Inthisstudy,weinvestigatestheriskfactorsthataffectthesurvivalandprognosisofpatientsa