摘要
【目的】探讨影响腹腔镜前列腺癌根治术后并发勃起功能障碍的高危因素。【方法】回顾性分析2019年6月至2023年6月本院收治的160例前列腺癌患者,均接受腹腔镜前列腺癌根治术,根据患者术后是否存在勃起功能障碍将患者分为障碍组和正常组。收集并整理患者的病历资料,采用多因素Logistic回归模型影响腹腔镜前列腺癌根治术后并发勃起功能障碍的相关因素,采用受试者工作特征(ROC)曲线评估列线图模型预测腹腔镜前列腺癌根治术后并发勃起功能障碍的效能。【结果】术后6个月,患者的国际勃起功能指数问卷表-5(IIEF-5)评分低于术前,差异有统计学意义(P<0.05)。160例患者中术后勃起功能障碍者46例(28.75%),剩余114例(71.25%)患者术后勃起功能正常。障碍组年龄、前列腺物异性抗原(PSA)、Gleason评分,以及吸烟史、酗酒史、临床分期T_(2)期所占比例均高于正常组,差异有统计学意义(P<0.05)。Logistic回归结果分析显示,高龄、PSA高、Gleason评分高、吸烟史、酗酒史、临床分期为T_(2)期均为腹腔镜前列腺癌根治术后并发勃起功能障碍的危险因素(P<0.05)。ROC曲线分析显示,列线图模型预测腹腔镜前列腺癌根治术后并发勃起功能障碍的灵敏度为0.870(95%CI:0.613~0.972),特异度为0.772(95%CI:0.563~0.871),曲线下面积(AUC)为0.893(95%CI:0.851~0.935)。【结论】患者高龄、PSA升高、Gleason评分升高、吸烟史、酗酒史、病理进展迅速均为腹腔镜前列腺癌根治术后并发勃起功能障碍的高危因素,临床医师可根据患者具体情况及时给予相关干预措施。
【Objective】To explore the high-risk factors affecting erectile dysfunction(ED)after laparoscopic radical prostatectomy.【Methods】A retrospective analysis was performed on 160 prostate cancer patients admitted from June 2019 to June 2023,all of whom underwent laparoscopic radical prostatectomy.Patients were divided into the ED group and normal group based on postoperative ED status.Medical records were collected,and multivariate Logistic regression was used to analyze factors associated with postoperative ED.The receiver operating characteristic(ROC)curve was drawn to evaluate the efficacy of the nomogram model in predicting ED after surgery.【Results】At 6 months postoperatively,the International Index of Erectile Function-5(IIEF-5)score was lower than the preoperative score,with a statistically significant difference(P<0.05).Among 160 patients,46(28.75%)developed postoperative ED,and 114(71.25%)had normal erectile function.The ED group had higher age,prostate-specific antigen(PSA),Gleason score,and higher proportions of smoking history,alcohol abuse history,and clinical stage T 2 compared with the normal group,with statistically significant differences(P<0.05).Logistic regression analysis showed that advanced age,elevated PSA,higher Gleason score,smoking history,alcohol abuse history,and clinical stage T 2 were risk factors for ED after laparoscopic radical prostatectomy(P<0.05).ROC curve analysis showed that the nomogram model had a sensitivity of 0.870(95%CI:0.613-0.972),specificity of 0.772(95%CI:0.563-0.871),and area under the curve(AUC)of 0.893(95%CI:0.851-0.935)for predicting postoperative ED.【Conclusion】Advanced age,elevated PSA,higher Gleason score,smoking history,alcohol abuse history,and rapid pathological progression are high-risk factors for ED after laparoscopic radical prostatectomy.Clinicians should provide relevant interventions in a timely manner based on specific patient conditions.
作者
张炳辉
方炜
马玉鹏
刘荣福
ZHANG Binghui;FANG Wei;MA Yupeng(Yangpu Hospital Affiliated to Tongji University,Shanghai 200080)
出处
《医学临床研究》
2025年第6期993-996,共4页
Journal of Clinical Research
