经尿道前列腺电切术同期膀胱造瘘术后造瘘管拔除影响因素分析  

Analysis of the relative factors affecting fistula tube removal after transurethral resection of prostate combined with cystostomy

作　　者：谢剑伟 殷波[2] XIE Jianwei;YIN Bo(Department of Urology,Zhongshan Hospital,Xiamen University,Xiamen 361000,China;Department of Urology,Shengjing Hospital of China Medical University,Shenyang 110004,China)

机构地区：[1]厦门大学附属中山医院泌尿外科,福建厦门361000 [2]中国医科大学附属盛京医院泌尿外科,沈阳110004

出　　处：《中国医科大学学报》2023年第4期289-293,共5页Journal of China Medical University

基　　金：国家自然科学基金(81372725);辽宁省重点研发计划(2017225038);辽宁省民生科技计划联合计划(2021JH2/10300099)。

摘　　要：目的探讨影响前列腺增生合并膀胱逼尿肌减弱患者行经尿道前列腺电切术(TURP)同期膀胱造瘘术后造瘘管拔除的相关因素。方法回顾性分析中国医科大学附属盛京医院2012年1月至2019年6月收治的93例前列腺增生合并膀胱逼尿肌减弱患者的临床资料。依据造瘘管拔除结果分为拔管组和未拔管组,对比2组患者的临床资料。采用单因素和多因素logistic分析,筛查影响造瘘管拔除的相关因素,同时通过构建操作者工作特征(ROC)曲线及诺曼图,预测造瘘管拔除的可能性。结果93例患者中,59例(63.44%)成功拔除造瘘管。术后口服α1-受体阻滞剂、高血压、前列腺体积、病程和逼尿肌压力是影响术后膀胱造瘘管拔除的相关因素。术后服用α1-受体阻滞剂、前列腺体积及膀胱逼尿肌压力是拔除造瘘管的保护性因素,病程是危险因素。结论对于前列腺增生合并膀胱逼尿肌减弱患者,术前应综合考虑其各项指标,并利用诺曼图提前预测造瘘管拔除的概率,制定适宜的手术方案。Objective To explore the relative factors affecting cystostomy tube removal in patients with prostatic hyperplasia and weakened bladder detrusor muscle who underwent transurethral resection of prostate(TURP)combined with cystostomy.Methods The clinical data of 93 patients with prostatic hyperplasia and weakened bladder detrusor muscle admitted to our hospital from January 2012 to June 2019 were retrospectively analyzed.Patients were divided into the extubation and non-extubation groups,based on the results of fistula tube extraction.Clinical parameters associated with the two groups were compared using univariate and logistic multivariate analyses to screen for relative factors affecting fistula tube extraction.ROC curves and Norman diagrams were created to predict the possibility of fistula tube extraction.Results Out of a total of 93 patients,59(63.44%)had their cystostomy tubes successfully removed.Univariate analysis and logistic multivariate regression analysis showed that the prostate volume,bladder detrusor muscle,and the postoperative oral administration ofα1-blocker were protective factors for cystostomy tube extraction;but the duration of disease was a risk factor.Conclusion For patients with prostatic hyperplasia and weakened bladder detrusor muscle,various indicators not limited to urodynamics should be considered before surgery.The Norman chart was used to predict the probability of cystostomy tube removal in advance,in order to develop an appropriate surgical plan for patients.

关 键 词：前列腺增生 膀胱逼尿肌 膀胱造瘘术 

分 类 号：R699.5[医药卫生—泌尿科学]