摘要
目的:分析经尿道前列腺等离子电切术(P KRP)后尿道狭窄发生率及危险因素.方法:选择我院自2015年1月至2019年3月收治的541例接受P KRP患者作为研究对象,随访6个月,分析术后尿道狭窄发生情况;根据是否并发尿道狭窄分为尿道狭窄组和尿道正常组,比较两组围术期各项信息,对有统计学意义的因素进行多因素Logistic回归分析,以Pearson相关性分析PKRP后尿道狭窄患者相关独立危险因素与最大尿流率的关系,使用受试者工作特征(ROC)曲线下面积(AUC)评价相关独立危险因素对P KRP后尿道狭窄的预测效能.结果:在541例接受P KRP患者中,共获得随访532例,随访率为98.34%;尿道狭窄31例,发生率为5.83%;经多因素Logistic回归分析,术前合并尿道感染、术中行尿道扩张整形、持续牵引时间、手术时间、术后留置导尿管时间均是P KRP后尿道狭窄的独立危险因素(P<0.05);经Pearson相关性分析,PKRP后尿道狭窄患者持续牵引时间、手术时间、术后留置导尿管时间均与最大尿流率呈负相关(r分别为-3.642、-2.985、-5.478,P分别为0.016、0.025、0.000);经ROC曲线分析,持续牵引时间、手术时间联合术后留置导尿管时间预测术前合并尿道感染或术中行尿道扩张整形的PKRP患者术后发生尿道狭窄的AUC为0.915,明显大于单一指标的AUC,差异均有统计学意义(P<0.05).结论:PKRP后尿道狭窄并不少见,与术前合并尿道感染、术中行尿道扩张整形、持续牵引时间、手术时间和术后留置导尿管时间有关,分析P KRP后尿道狭窄的危险因素,有助于预测尿道狭窄发生,值得临床予以重视.
Objective:To analyze the incidence and risk factors of urethral stricture after transurethral prostate plasmatomy(PKRP).Methods:541 patients with PKRP admitted to our hospital from January 2015 to March 2019 were selected as the research objects,followed up for 6 months to analyze the occurrence of postoperative urethral stricture.According to whether or not urethral stricture was complicated,they were divided into two groups:urethral stricture group and urethral normal group.Compared the perioperative information of the two groups,the factors with statistical significance were analyzed by logistic regression analysis.Pearson correlation was used to analyze the relationship between the independent risk factors and the maximum flow rate in patients with PKRP posterior urethral stricture.Results:Among 541 patients who received PKRP,532 cases were followed up,with a follow-up rate of 98.34%;31 cases of urethral stricture,with a incidence of 5.83%;by multiple factor Logistic regression analysis,preoperative urethral infection,intraoperative urethral dilatation and plastic surgery,continuous traction time,operation time and postoperative catheter retention time were independent risk factors of urethral stricture after PKRP(P<0.05);According to Pearson correlation analysis,the duration of traction,operation time and indwelling catheter time were negatively correlated with the maximum urinary flow rate(r-3.642,-2.985,-5.478,P 0.016,0.025,0.000,respectively);According to ROC curve analysis,the AUC of urethral stricture in PKRP patients with preoperative urethral infection or intraoperative urethral dilatation was 0.915,which was significantly higher than that of single index(P<0.05).Conclusion:The urethral stricture after PKRP is not uncommon.It is related to preoperative urethral infection,intraoperative urethral dilatation,continuous traction time,operation time and postoperative indwelling catheter time.The analysis of risk factors of urethral stricture after PKRP is helpful to predict the occurrence of urethral stricture,which is worthy of clinical attention.
作者
冯伟
朱笑丛
胡雅芳
FENG Wei;ZHU Xiaocong;HU Yafang(Beijing Jishuitan Hospital,Beijing 100096,China)
出处
《河北医学》
CAS
2020年第7期1195-1200,共6页
Hebei Medicine
基金
北京市优秀人才培养资助项目,(编号:2015000021467G179)。
关键词
良性前列腺增生
经尿道前列腺等离子电切术
尿道狭窄
危险因素
Benign prostatic hyperplasia
Transurethral resection of prostate plasma
Urethral stricture
Risk factors
