良性前列腺增生继发急性尿潴留拔尿管后再次导尿的危险因素分析  

Risk factors of the failure of trial without catheter in patients with acute urinary retention due to benign prostatic hyperplasia

作　　者：张焕涛 陆身修 李腾林 宋文 淡明江 Zhang Huantao;Lu Shenxiu;Li Tenglin;Song Wen;Dan Mingjiang(Department of Urology,Hui Ya Hospital of the First Affiliated Hospital,Sun Yat-sen University,Huizhou 516081,China)

机构地区：[1]中山大学附属第一医院惠亚医院泌尿外科,惠州516081

出　　处：《中华全科医师杂志》2024年第5期494-498,共5页Chinese Journal of General Practitioners

基　　金：惠州市科技计划项目(2021WC0106321)。

摘　　要：回顾性分析2021年3月至2023年3月在中山大学附属第一医院惠亚医院收治的62例良性前列腺增生继发首次急性尿潴留患者的临床资料。所有患者均接受留置尿管及口服0.4 mg/d盐酸坦索罗辛,并在第3天试行拔除尿管(TWOC),据此分为TWOC成功组(32例,51.61%)和失败组(30例,48.39%),比较两组的年龄、国际前列腺症状评分(IPSS)、前列腺体积、膀胱内前列腺突出度(IPP)及导尿后尿量等,并分析TWOC失败的影响因素。单因素及多因素logistic回归分析显示,IPSS评分(重度)、直肠指诊时前列腺疼痛、IPP>5 mm是TWOC失败的危险因素(OR=0.193、0.119、0.907、0.070;P<0.05)。三者联合预测因子受试者工作特征曲线下面积为0.857(95%CI:0.764~0.949,P<0.001)。需关注良性前列腺增生继发急性尿潴留患者的IPSS评分、直肠指诊时是否出现前列腺疼痛以及IPP,可为初步评估TWOC结果提供一定指导价值。The clinical data of 62 patients with first episode of acute urinary retention(AUR)due to benign prostate hyperplasia(BPH)admitted in Hui Ya Hospital from March 2021 to March 2023 were retrospectively analyzed.All patients underwent urinary catheterization and were started on tamsulosin(4 mg/day),followed by trial without catheter(TWOC)after 3 days.There were 32 cases(51.61%)with TWOC success(success group)and 30 cases(48.39%)with TWOC failure(failure group).Age,international prostate symptom score(IPSS),intravesical prostatic protrusion(IPP),prostate volume,and urine volume after catheterization were compared between two groups.The factors related to TWOC failure were analyzed with univariate and multivariate logistic analyses.The results showed that IPSS scores(ⅡandⅢ),prostate pain during digital rectal examination(DRE),and IPP>5 mm(OR=0.193,0.119,0.907,0.070;P<0.05)were independent risk factors of TWOC failure.The area under the ROC of the combination of above indicators for predicting TWOC failure was 0.857(95%CI:0.764-0.949,P<0.001),indicating that it can provide certain guidance for TWOC failure in patients with AUR due to BPH.

关 键 词：尿潴留 前列腺增生 危险因素 试行拔除尿管试验 

分 类 号：R697.3[医药卫生—泌尿科学]