经尿道前列腺钬激光剜除术的前列腺增生症患者术后下尿路症状影响因素分析  

Influencing factors of lower urinary tract symptoms in patients with prostate hyperplasia after transurethral holmium laser enucleation

作　　者：徐挺[1] 胡俊彪[1] 朱永锋[1] 吴慧玲[1] Xu Ting;Hu Junbiao;Zhu Yongfeng;Wu Huiling(Department of Urology,Jinhua People's Hospital,Jinhua 321000,China)

机构地区：[1]浙江省金华市人民医院泌尿外科,金华321000

出　　处：《中华全科医师杂志》2023年第7期732-735,共4页Chinese Journal of General Practitioners

摘　　要：本研究为回顾性研究。选取2019年7月至2022年12月在浙江省金华市人民医院泌尿外科收治的360例经尿道前列腺钬激光剜除术的前列腺增生症患者,统计术后1个月的下尿路症状发生率;根据是否出现下尿路症状将患者分成观察组与对照组,比较两组患者临床资料的差异性,并分析术后下尿路症状的影响因素。360例患者术后1个月发生下尿路症状40例,发生率为11.11%;两组的病程、术前前列腺体积、术前IPSS评分、术前最大尿流率、术前残余尿量、术后尿路感染、术后导尿管留置时间比较,差异有统计学意义(t=28.01、6.35、8.79、17.92、34.84、11.45;P<0.05);多因素logistic分析结果显示,病程、术前前列腺体积、术前IPSS评分、术后尿路感染、术后导尿管留置时间是术后下尿路症状的危险因素(OR=6.964、3.442、1.944、4.836、4.225、4.894),术前最大尿流率是其保护因素(OR=0.043)。提示经尿道前列腺钬激光剜除术患者术后下尿路症状的发生率较高,其影响因素多,应采取有效的防护措施,以降低术后下尿路症状发生率,促进患者尽早康复。A total of 360 patients with prostate hyperplasia underwent transurethral holmium laser enucleation of the prostate in Department of Urology of Jinhua People′s Hospital from July 2019 to December 2022.Among 360 patients,lower urinary tract symptoms occurred one month after operation in 40 cases with an incidence rate of 11.11%.The age,body mass index(BMI),course of disease,nature of disease,preoperative prostate volume,postoperative prostate volume,preoperative IPSS score,postoperative IPSS score,preoperative maximum urine flow rate,postoperative maximum urine flow rate,preoperative residual urine volume,postoperative residual urine volume,postoperative urinary tract infection,operative time,postoperative catheter retention time were compared between patients with lower urinary tract symptoms(study group)and those without(control group).There were significant differences in the course of disease,preoperative prostate volume,preoperative IPSS score,preoperative maximum urine flow rate,preoperative residual urine volume,postoperative urinary tract infection and postoperative catheter retention time between two groups(t=28.01,6.35,8.79,17.92,34.84,11.45;all P<0.05).Multivariate logistic analysis showed that the course of disease,preoperative prostate volume,preoperative IPSS score,postoperative urinary tract infection,and postoperative catheter retention time were independent risk factors for postoperative lower urinary tract symptoms(OR=6.964,3.442,1.944,4.836,4.225,4.894;all P<0.05);while the preoperative maximum urinary flow rate was the protective factor(OR=0.043,P<0.05).The incidence of postoperative lower urinary tract symptoms in patients undergoing transurethral holmium laser enucleation of prostate is high.Effective protective measures should be taken based on the risk factors to reduce the incidence of postoperative lower urinary tract symptoms and to promote the early recovery of patients.

关 键 词：前列腺增生症 经尿道前列腺钬激光剜除术 下尿路症状 影响因素 

分 类 号：R699.8[医药卫生—泌尿科学]