老年患者下尿路微创手术术后发生膀胱痉挛的影响因素分析  

Risk factors for bladder spasms in elderly patients after minimally invasive surgery of the lower urinary tract

作　　者：马天明 王佳文 刘晓东 孟令峰[1,2] 张威 张耀光[1,2] Ma Tianming;Wang Jiawen;Liu Xiaodong;Meng Lingfeng;Zhang Wei;Zhang Yaoguang(Department of Urology,Beijing Hospital,National Center of Gerontology,Institute of Geriatric Medicine,Chinese Academy of Medical Sciences,Beijing 100730,China;Graduate School of Peking Union Medical College,Chinese Academy of Medical Sciences,Beijing 100730,China)

机构地区：[1]北京医院泌尿外科,国家老年医学中心,北京100730 [2]中国医学科学院老年医学研究院,北京100730

出　　处：《中华老年医学杂志》2022年第1期66-70,共5页Chinese Journal of Geriatrics

基　　金：中央高校基本科研业务费专项资金资助(3332020069);北京市科技计划项目:人工智能肾癌(Z201100005620007)。

摘　　要：目的探讨老年患者下尿路微创手术术后发生膀胱痉挛的危险因素。方法收集2016年7月至2016年9月全国87家医学中心行膀胱、前列腺、尿道相关微创手术的老年患者病例资料,按照膀胱痉挛发生情况分为痉挛组和对照组,比较两组患者基本信息和临床资料,并分析术后发生膀胱痉挛的可能影响因素。结果共纳入患者1275例,年龄65~96岁,平均(73.4±6.1)岁。606例(47.5%)发生膀胱痉挛。单因素分析显示,与对照组比较,痉挛组患者在性别、年龄、便秘、术前应用影响膀胱功能药物和手术部位方面差异有统计学意义(均P<0.05);两组患者在民族、体重指数(BMI)、吸烟、饮酒、咖啡因摄入、婚姻状况方面差异无统计学意义(均P>0.05)。Logistic回归分析显示高龄(OR=1.310,P=0.007)、男性(OR=0.595,P=0.030)、术前应用影响膀胱功能药物(OR=0.510,P=0.002)、便秘(OR=0.627,P<0.001)是老年患者下尿路微创手术术后发生膀胱痉挛的独立影响因素。结论年龄越大、男性、术前应用影响膀胱功能药物、合并便秘是老年患者下尿路微创手术术后发生膀胱痉挛的危险因素,术前进行针对性干预,可预防膀胱痉挛发生。Objective To investigate the risk factors for bladder spasms in elderly patients after minimally invasive surgery of the lower urinary tract.Methods Clinical data of elderly patients from 87 medical centers across the country who had received minimally invasive surgery of the bladder,prostate,or urethra from July 2016 to September 2016 were retrospectively analyzed.Based on the occurrence of bladder spasms,patients were divided into the spasm group and the control group.General information and clinical data were compared between the two groups,and potential risk factors for bladder spasms after surgery were analyzed.Results A total of 1275 patients were enrolled,aged from 65 to 96 years,with an average age of(73.4±6.1).Bladder spasms occurred in 606(47.5%)of all patients.Univariate analysis showed that,compared with the control group,patients in the spasm group had statistically significant differences in gender,age,constipation,preoperative use of drugs,and surgical site(all P<0.05),while there were no significant differences between the two groups in ethnicity,body mass index(BMI),smoking,drinking,caffeine intake,and marital status(all P>0.05).Logistic regression analysis showed that advanced age(OR=1.310,P=0.007),male(OR=0.595,P=0.030),preoperative use of drugs(OR=0.510,P=0.002)affecting bladder function,and constipation(OR=0.627,P<0.001)were independent influencing factors for bladder spasms in elderly patients after minimally invasive surgery of the lower urinary tract(P<0.05).Conclusions Old age,male,preoperative use of drugs affecting bladder function,and constipation are risk factors for bladder spasms after minimally invasive lower urinary tract surgery in elderly patients.These findings can be used for guiding clinicians to conduct targeted interventions before surgery to prevent bladder spasms.

关 键 词：膀胱 过度活动性 外科手术 微创性 

分 类 号：R699[医药卫生—泌尿科学]