良性前列腺增生患者电切术后尿道狭窄的危险因素及联合预测模型的建立和验证  

Risk factors of urethral stricture after transurethral resection of benign prostatic hyperplasia and the establishment and validation of a combined prediction model

作　　者：桂豪军 段成斌 王二宾 GUI Hao-jun;DUAN Cheng-bin;WANG Er-bin(Department of Urology,Chengdu Office Hospital of Tibet Autonomous Region People's Government,Chengdu 610041,Sichuan,CHINA)

机构地区：[1]西藏自治区人民政府驻成都办事处医院泌尿外科,四川成都610041

出　　处：《海南医学》2024年第24期3533-3537,共5页Hainan Medical Journal

摘　　要：目的探究良性前列腺增生患者电切术后尿道狭窄的危险因素,并建立联合预测模型,评估联合模型的预测效能。方法回顾性分析2020年12月至2023年12月西藏自治区人民政府驻成都办事处医院收治的177例良性前列腺增生手术治疗患者的临床资料,根据患者是否发生术后尿道狭窄分为对照组142例和狭窄组35例。比较两组患者的基线资料和围术期指标,采用Logistic多因素回归分析患者术后尿道狭窄独立危险因素并建立联合预测模型,采用受试者工作特征(ROC)曲线分析联合模型预测患者术后尿道狭窄的效能。结果两组患者的年龄、病程、体质量指数(BMI)、个人收入、合并疾病、学历、膀胱冲洗时间比较差异均无统计学意义(P>0.05),但两组患者的前列腺体积、国际前列腺症状评分(IPSS)评分、术前尿路感染患者占比、手术时间、术中出血量、前列腺切除量、术后尿道牵引时间、尿管留置时间、经尿道前列腺切除术(TURP)术式、术后尿路感染患者占比、术前导尿患者占比比较差异均有统计学意义(P<0.05);多因素Logistic回归分析结果显示,前列腺体积、IPSS评分、术前尿路感染、手术时间、术中出血量、前列腺切除量、术后尿道牵引时间、尿管留置时间、手术方式、术后尿路感染、术前导尿均是良性前列腺增生患者电切术后尿道狭窄独立影响因素(P<0.05);整合患者指标表达建立联合模型,ROC曲线分析结果显示,联合模型ROC曲线下面积(AUC)为0.920,标准误为0.022,95%CI为0.876~0.964,具有较高预测效能。结论良性前列腺增生患者电切患者术后尿道狭窄受患者病情及手术方式等因素影响,前列腺体积、IPSS评分、术前尿路感染、手术时间、术中出血量、前列腺切除量、术后尿道牵引时间、尿管留置时间、手术方式、术后尿路感染、术前导尿均是良性前列腺增生患者电切术后尿道狭窄独立�Objective To explore the risk factors of urethral stricture after transurethral resection of benign prostatic hyperplasia(BPH)and to establish a combined prediction model to evaluate its predictive performance.Methods A retrospective analysis was conducted on the clinical data of 177 patients with BPH who underwent surgical treatment in Chengdu Office Hospital of Tibet Autonomous Region People's Government from December 2020 to December 2023.The patients were divided into a control group(142 cases)and a stricture group(35 cases)according to whether postoperative urethral stricture occurred.The baseline data and perioperative indicators of the two groups were compared.Independent risk factors of postoperative urethral stricture were identified using multivariable logistic regression analysis to establish a joint prediction model.The receiver operating characteristic(ROC)curve was used to analyze the prediction performance of the combined model.Results There were no significant differences in age,course of disease,body mass index(BMI),personal income,comorbidities,educational background,and bladder irrigation time between the two groups(P>0.05).However,there were statistically significant differences in prostate volume,IPSS score,proportion of patients with preoperative urinary tract infection,operation time,intraoperative blood loss,prostate resection volume,postoperative urethral traction time,urinary catheter indwelling time,TURP operation type,proportion of patients with postoperative urinary tract infection,and proportion of patients with preoperative catheterization between the two groups(P<0.05).Multivariate logistic regression analysis showed that prostate volume,IPSS score,preoperative urinary tract infection,operation time,intraoperative blood loss,prostate resection volume,postoperative urethral traction time,catheter indwelling time,surgical method,postoperative urinary tract infection,and preoperative catheterization were independent influencing factors for urethral stricture after TURP in patients wit

关 键 词：前列腺增生 尿道狭窄 危险因素 联合预测模型 效能分析 

分 类 号：R6973[医药卫生—泌尿科学]