经尿道前列腺电切术后低钠血症的危险因素分析  

The Analysis of Risk Factors of Hyponatremia after Transurethral Resection of Prostate

作　　者：冯艳红[1] 姜华茂[1] 刘宇[2] 侯铁汉[2] 张春阳[1] 傅德望[1] 

机构地区：[1]辽宁医学院附属第一医院超声科,辽宁锦州121001 [2]葫芦岛市中心医院泌尿科,辽宁葫芦岛125001

出　　处：《中国医科大学学报》2011年第9期803-806,共4页Journal of China Medical University

基　　金：辽宁省科学技术计划项目(2010225034);辽宁省教育厅高校科研计划(20060516)

摘　　要：目的探讨经尿道前列腺切除术(TURP)术后血钠降低的危险因素。方法对216例诊断为良性前列腺增生症并行TURP病例,对其临床资料进行分析。以冲洗液类型、患者年龄、术前是否膀胱造瘘、前列腺切除质量、前列腺体积、是否合并心血管疾病、是否合并糖尿病、手术时间、术中是否存在前列腺包膜或膀胱穿孔为自变量,以手术前后血钠差为因变量,进行单因素和多因素非条件Logistic回归分析。结果单因素分析结果显示:年龄(P=0.005)、前列腺切除质量(P<0.001)、手术时间(P=0.005)和前列腺包膜或膀胱穿孔(P=0.002)是TURP术后血钠降低的危险因素。多因素回归分析表明TURP术后血钠降低的危险因素为年龄(P=0.005,OR=2.499)、前列腺切除质量(P<0.001,OR=3.524)、手术时间(P=0.022,OR=2.241)、前列腺包膜或膀胱穿孔(P=0.002,OR=3.990);保护因素可能为5%甘露醇冲洗液(P=0.172,OR=0.564)。结论年龄≥70岁、前列腺切除质量≥30 g、手术时间≥90 min和前列腺包膜或膀胱穿孔是TURP术后血钠降低的危险因素;5%甘露醇冲洗液可能为TURP术后血钠降低的保护因素。Objective To observe the risk factors of hyponatremia after transurethral resection of prostate（TURP）.Methods To select 216 cases of patients with benign prostatic hyperplasia were undergone TURP from April 2002 to May 2010,analyzed the clinical data.The fluid type,patient age,preoperative bladder fistula,resection of the prostate weight,prostate volume,a merger of the cardiovascular diseases,diabetes mellitus,operating time,whether there was prostatic capsule or bladder perforation as independent variables,hyponatremia difference before and after surgery as the dependent variable,single and multivariate non-conditional logistic regression analysis was taken.Results Univariate analysis showed that age（P =0.005）,resection of the prostate weight（P 0.001）,operating time（P =0.005） and the prostatic capsule or bladder perforation（P = 0.002） were risk factors of hyponatremia after TURP.Multivariate regression analysis showed that the risk factors were age（P =0.005,OR =2.499）,resection of the prostate weight（P 0.001,OR =3.524）,operating time（P =0.022,OR =2.241）,prostatic capsule or bladder perforation（P =0.002,OR =3.990）.Protective factors might be 5% mannitol irrigation fluid（P =0.172,OR =0.564）.Conclusion Age≥70 years,prostatectomy weight ≥30 g,operating time ≥90 min and the prostatic capsule or bladder perforation were the risk factors of hyponatremia after TURP.5% mannitol irrigation fluid might be the protective factor.

关 键 词：经尿道前列腺电切术 低钠血症 危险因素 回归分析 

分 类 号：R697.32[医药卫生—泌尿科学]