经尿道前列腺等离子剜切术患者围手术期出血情况及其相关因素分析  

Analysis of perioperative bleeding and its related factors in patients undergoing transurethral plasma kinetic prostatectomy

作　　者：朱可柯 刘魁 王增利 Zhu Keke;Liu Kui;Wang Zengli(Department of Urology Surgery,Xi′an LinTong People′s Hospital,Xi′an 710600,China;Department of Urology Surgery,Weinan Central Hospital,Weinan 714000,China)

机构地区：[1]西安市临潼区人民医院泌尿外科,西安710600 [2]渭南市中心医院泌尿外科,渭南714000

出　　处：《国际外科学杂志》2024年第9期636-640,共5页International Journal of Surgery

摘　　要：目的探讨经尿道前列腺等离子剜切术(TUPKP)患者的围手术期出血情况,并分析相关影响因素。方法回顾性分析2021年3月—2024年3月西安市临潼区人民医院收治的206例TUPKP患者的病历资料,患者年龄51~83岁,平均(64.33±9.74)岁;病程1~7年,平均(4.57±1.59)年。观察患者围手术期出血情况并据此分组,其中出血组108例(52.43%),未出血组98例(47.57%)。对比组间一般资料、实验室数据等,多因素Logistic回归分析TUPKP患者围手术期出血的影响因素。结果出血组糖尿病、术后便秘占比高于未出血组,前列腺体积、手术时间高于未出血组(P<0.05)。出血组血清钙、血小板计数(PLT)和活化部分凝血活酶时间(APTT)低于未出血组(P<0.05)。多因素Logistic回归分析结果显示,糖尿病(OR=4.283)、前列腺体积(OR=1.111)、手术时间(OR=1.091)和术后便秘(OR=4.144)是TUPKP患者围手术期出血的危险因素(P<0.05);血清钙(OR=0.001)和PLT(OR=0.980)是TUPKP患者围手术期出血的保护因素(P<0.05)。结论TUPKP患者围手术期出血风险较大;糖尿病、前列腺体积、手术时间和术后便秘是其危险因素,血清钙和PLT是其保护因素。Objective To investigate the perioperative bleeding of patients undergoing transurethral plasma kinetic prostatectomy(TUPKP)and analyze the related influencing factors.Methods Retrospectively analyzed the clinical data of 206 patients with TUPKP admitted to Xi′an Lintong District People′s Hospital from March 2021 to March 2024,all patients were aged from 51 to 83 years old,with an average of(64.33±9.74)years;patients′course of disease was 1 to 7 years,averaged(4.57±1.59)years.and the perioperative bleeding of patients was observed and divided into bleeding group(n=108)and non-bleeding group(n=98).By comparing the general data and laboratory data between groups,the influencing factors of perioperative bleeding in TUPKP patients were analyzed by multivariate Logistic regression.Results The proportion of diabetes and postoperative constipation in bleeding group was higher than that in non-bleeding group,and the prostate volume and operation time were higher than that in non-bleeding group(P<0.05).Serum calcium,platelet count(PLT)and activated partial thromboplastin time(APTT)in bleeding group were lower than those in non-bleeding group(P<0.05).Multivariate Logistic regression analysis showed that diabetes(OR=4.283),prostate volume(OR=1.111),operation time(OR=1.091)and postoperative constipation(OR=4.144)were the risk factors for perioperative bleeding in TUPKP patients(P<0.05).Serum calcium(OR=0.001)and PLT(OR=0.980)are the protective factors for perioperative bleeding in TUPKP patients(P<0.05).Conclusion The rate of perioperative bleeding in TUPKP patients is of great risk.Diabetes,prostate volume,operation time and postoperative constipation are its risk factors,and serum calcium and PLT are its protective factors.

关 键 词：糖尿病 前列腺增生 便秘 出血 危险因素 

分 类 号：R699.8[医药卫生—泌尿科学]