前列腺体积和手术时间与老年患者经尿道前列腺汽化电切术后尿道狭窄的相关性分析  

Analysis of the correlation between prostate volume and operation time and urethral stricture after transurethral vaporization resection of prostate in elderly patients

作　　者：生文龙 沈玉霞 李娟 Sheng Wenlong;Shen Yuxia;Li Juan(Operating Room,Suzhou Jiulong Hospital,Medical College of Shanghai Jiaotong University,Suzhou,Jiangsu,215028,P.R.China)

机构地区：[1]上海交通大学医学院苏州九龙医院手术室,江苏苏州215028

出　　处：《老年医学与保健》2022年第6期1374-1378,共5页Geriatrics & Health Care

摘　　要：目的评估经尿道前列腺汽化电切术治疗的老年患者术后尿道狭窄的危险因素。方法回顾性分析2019年7月—2022年2月在上海交通大学医学院苏州九龙医院行前列腺电切术治疗的老年良性前列腺增生患者的临床资料。本研究为病例对照研究,以是否发生尿道狭窄将患者分为观察组和对照组。收集患者一般临床资料和患者围手术期情况。采用Logistic回归分析筛选经尿道前列腺汽化电切术术后尿道狭窄的危险因素。结果观察组体质量指数高于对照组(P=0.043)。观察组既往有导尿史患者比例(P=0.021)、术前导尿患者比例(P=0.037)、术前合并尿路感染患者比例(P=0.010)、既往有糖尿病病史患者比例(P=0.033)高于对照组。观察组前列腺体积(P=0.049)、IPSS评分(P<0.001)、术中出血量(P=0.010)、术中切除前列腺组织质量(P=0.030)、手术时间(P<0.001)、术后留置导尿管时间(P<0.001)、术后导尿管牵拉时间(P=0.012)高于对照组。既往导尿史(OR=1.08,P=0.038)、术前导尿(OR=1.65,P=0.026)、术前合并尿路感染(OR=1.19,P=0.007)、糖尿病病史(OR=1.57,P=0.049)、前列腺体积(OR=1.86,P=0.009)、IPSS评分(OR=1.71,P=0.005)、术中切除质量(OR=1.31,P=0.003)、手术时间(OR=1.83,P=0.002)以及术后留置导尿管时间(OR=1.32,P=0.025)是前列腺电切术后尿道狭窄的危险因素。前列腺体积(OR=1.64,P=0.014)和手术时间(OR=1.57,P=0.004)是前列腺电切术后尿道狭窄的独立危险因素。前列腺体积、手术时间以及两者联合指标AUC分别为0.62(P=0.021),0.56(P=0.037)和0.78(P=0.006)。结论前列腺体积大小和手术操作时间是经尿道前列腺汽化电切术术后尿道狭窄的独立危险因素。两者联合指标对经尿道前列腺汽化电切术术后尿道狭窄具有较好的预测效能,具有一定临床价值。Objective To evaluate the risk factors of urethral stricture after transurethral vaporization resection of prostate(TURP)in elderly patients.Methods The clinical data of elderly patients with benign prostatic hyperplasia who underwent TUVP in Suzhou Jiulong Hospital,Medical College of Shanghai Jiaotong University from July 2019 to February 2022 were retrospectively analyzed.This study was a case-control study.The patients were divided into observation group and control group according to whether urethral stricture occurred.The general clinical data and perioperative conditions of the patients were collected.Logistic regression analysis was used to screen the risk factors of urethral stricture after TUVP.Results The body mass index of the observation group was higher than that of the control group(P=0.043).The proportion of patients with previous catheterization history(P=0.021),preoperative catheterization(P=0.037),preoperative urinary tract infection(P=0.010),and previous diabetes history(P=0.033)in the observation group were higher than those in the control group.The prostate volume(P=0.049),IPSS score(P<0.001),intraoperative blood loss(P=0.010),weight of prostate tissue excised during operation(P=0.030),operative time(P<0.001),postoperative indwelling catheter time(P<0.001),postoperative catheter pulling time(P=0.012)in the observation group were higher or longer than those in the control group.Previous catheterization history(OR=1.08,P=0.038),preoperative urethral catheterization(OR=1.65,P=0.026),preoperative complicated urinary tract infection(OR=1.19,P=0.007),diabetes history(OR=1.57,P=0.049),prostate volume(OR=1.86,P=0.009),IPSS score(OR=1.71,P=0.005),weight of prostate tissue excised during operation(OR=1.31,P=0.003),operative time(OR=1.83,P=0.002)and postoperative indwelling catheter time(OR=1.32,P=0.025)were risk factors for urethral stricture after electroprostatectomy.The AUC of prostate volume,operative time and their combination were 0.62(P=0.021),0.56(P=0.037)and 0.78(P=0.006),respectively.Conclusi

关 键 词：老年 良性前列腺增生 经尿道前列腺汽化电切术 尿道狭窄 

分 类 号：R699.8[医药卫生—泌尿科学]