良性前列腺增生患者TURP术后复发的因素探讨基于倾向性评分匹配法  

Factors of Relapse after TURP in Patients with Benign Prostatic Hyperplasia:Based on Propensity Score Matching Method

作　　者：宋伟航 韩广业[1] 李泽宇 张春锋 SONG Wei-hang;HAN Guang-ye;LI Ze-yu;ZHANG Chun-feng(Department of Urology Surgery,The First Affiliated Hospital of Xinxiang Medical University,Xinxiang 453100,Henan Province,China)

机构地区：[1]新乡医学院第一附属医院泌尿外科,河南新乡453100

出　　处：《罕少疾病杂志》2025年第3期120-123,共4页Journal of Rare and Uncommon Diseases

基　　金：河南省医学科技攻关计划(LHGJ20220607)。

摘　　要：目的 基于倾向性评分匹配法(PSM)探究影响良性前列腺增生(BPH)患者经尿道前列腺切除术(TURP)术后复发的因素。方法 回顾性分析2021年1月至2022年12月本院收治的417例行TURP治疗的BPH患者临床资料,根据术后是否复发分为复发组(76例),非复发组(341例),比较2组患者的一般资料。采用PSM对复发组和非复发组患者进行1:1匹配,匹配后2组分别纳入70例患者,采用单因素与多因素Cox回归分析探讨影响BPH患者TURP术后复发的危险因素。结果 BPH患者TURP术后复发率为17.51%;PSM前复发组合并高脂血症患者占比、切除组织重量、手术持续时间高于非复发组(P<0.05),BMI、术前QOL评分、术后置管时间低于非复发组(P<0.05);PSM后复发组前列腺增生程度Ⅲ度占比高于非复发组(P<0.05);PSM前后复发组年龄,合并高血压、糖尿病占比,术前IPSS评分,PVR,TPV,血清PSA均高于非复发组(P<0.05),Qmax均低于非复发组(P<0.05);多因素Cox回归分析结果显示年龄、合并高血压、合并糖尿病、前列腺增生Ⅲ度、术前IPSS评分、血清PSA均为BPH患者TURP术后复发的危险因素(HR=1.980、2.387、1.685、2.328、2.208、1.766,P<0.05)。结论 基于PSM分析得出,BPH患者TURP术后复发的危险因素包括年龄、合并高血压、合并糖尿病、前列腺增生Ⅲ度、术前IPSS评分、血清PSA。Objective To explore the factors influencing the recurrence of patients with benign prostatic hyperplasia(BPH)after Transurethral resection of the prostate(TURP)based on propensity score matching(PSM).Methods Clinical data of 417 BPH patients treated with TURP from January 2021 to December 2022 in our hospital were retrospectively analyzed,and they were divided into recurrence group(76 cases)and non-recurrence group(341 cases)according to postoperative recurrence,and the general data of the two groups were compared.PSM was used to match patients in the relapsing group and the non-relapsing group 1:1,and 70 patients were included in each group after matching.Univariate and multivariate Cox regression analysis were used to explore the risk factors affecting the recurrence of postoperative TURP in BPH patients.Results The recurrence rate of patients with BPH after TURP was 17.51%.Before PSM,the proportion of patients with hyperlipidemia,the weight of resected tissue and duration of operation in the recurrence group was higher than those in the non-recurrence group(P<0.05),and BMI,preoperative QOL score and postoperative catheterization time were lower than those in the non-recurrence group(P<0.05).After PSM,the proportion of gradeⅢprostatic hyperplasia in recurrence group was higher than that in non-recurrence group(P<0.05).Before and after PSM,the age,the proportion of patients with hypertension and diabetes,IPSS score,PVR,TPV and serum PSA in the recurrence group were higher than those in the non-recurrence group(P<0.05),and the Q max was lower than that in the non-recurrence group(P<0.05).Multivariate Cox regression analysis showed that age,hypertension,diabetes,BPH gradeⅢ,preoperative IPSS score and serum PSA were all risk factors for recurrence of BPH patients after TURP(HR=1.980,2.387,1.685,2.328,2.208,1.766,P<0.05).Conclusion Based on PSM analysis,the risk factors for recurrence of BPH patients after TURP include age,hypertension,diabetes,gradeⅢprostatic hyperplasia,preoperative IPSS score and serum PSA

关 键 词：良性前列腺增生 经尿道前列腺切除术 复发 因素 

分 类 号：R588.1[医药卫生—内分泌]