摘要
目的探讨经尿道前列腺等离子电切术后失血量的影响因素,构建预测模型并验证。方法选取2022年1月至2024年10月抚州市第一人民医院行经尿道前列腺等离子电切术的180例良性前列腺增生患者为研究对象,根据术后出血量分为观察组(冲洗液含血量>30 mg/h,n=58)与对照组(冲洗液含血量≤30 mg/h,n=122)。收集两组的临床资料,分析经尿道前列腺等离子电切术术后失血量的危险因素,进行单因素分析和多因素logistic回归分析,采用R语言软件构建列线图预测模型进行验证。结果单因素分析结果显示,手术时间、糖尿病、术前服用抗血小板药物、术中损伤包膜、术中止血不彻底、术后膀胱痉挛与术后出血量大有关,差异有统计学意义(P<0.05);多因素logistic回归模型分析结果显示,手术时间(β=0.145,OR=1.156,95%CI:1.095~1.220)、术前服用抗血小板药物(β=2.022,OR=7.557,95%CI:2.837~20.132)、术中损伤包膜(β=1.016,OR=2.761,95%CI:1.098~6.943)、术后膀胱痉挛(β=1.388,OR=4.006,95%CI:1.595~10.063)是术后出血量大的独立危险因素(P<0.05);列线图模型预测失血量的风险CI为0.894(0.831~0.957);模拟预测术后失血量大的风险阈值>0.17。结论本研究旨在全面探讨经尿道前列腺等离子电切术后失血量的影响因素以构建列线图预测模型,为临床准确预测术后出血风险提供有力工具,以更好地指导临床实践,改善患者预后。临床上需注意上述危险因素。
Objective To investigate the influencing factors of postoperative blood loss after transurethral plasma kinetic prostatectomy of prostate and establish a prediction model and verify it.Methods A total of 180 patients with benign prostatic hyperplasia who received transurethral plasma kinetic prostatectomy of the prostate in the First People's Hospital of Fuzhou City from January 2022 to October 2024 were selected as the study objects.According to the postoperative blood loss,they were divided into observation group(blood content of flushing solution>30 mg/h,n=58)and control group(blood content of flushing solution≤30 mg/h,n=122).The clinical data of the two groups were collected,and the risk factors of blood loss after transurethral plasma kinetic prostatectomy of prostate were analyzed.Univariate analysis and multivariate logistic regression analysis were carried out,and the nomogram prediction model was constructed with R language software for venification.Results The results of the univariate analysis showed that the operative time,diabetes mellitus,preoperative use of antiplatelet drugs,intraoperative injury to the capsule,incomplete intraoperative hemostasis,postoperative bladder spasm were related to a large amount of postoperative bleeding,and the differences were statistically significant(P<0.05).Multivariate logistic regression model analysis showed that operation time(β=0.145,OR=1.156,95%CI:1.095-1.22),preoperative use of antiplatelet drugs(β=2.022,OR=7.557,95%CI:2.837-20.132),intraoperative injury to the capsule(β=1.016,OR=2.761,95%CI:1.098-6.943),postoperative bladder spasm(β=1.388,OR=4.006,95%CI:1.595-10.063)were independent risk factors for postoperative blood loss(P<0.05).The CI of risk predicted by the nomogram model was 0.894(0.831-0.957).The risk threshold of large postoperative blood loss predicted by simulation was>0.17.Conclusion The purpose of this study is to comprehensively investigate the influencing factors of blood loss after transurethral plasma kinetic prostatectomy of the prostate,to build a nomogram prediction model,to provide a powerful tool for accurately predicting the risk of postoperative,to better guide clinical practice and improve patient prognosis.Clinically,the above-mentioned risk factors should be noted.
作者
周丽萍
黄佳琦
吴芳卉
ZHOU Liping;HUANG Jiaqi;WU Fanghui(Department of Anesthesiology,the First People's Hospital of Fuzhou City,Jiangxi Province,Fuzhou 344000,China)
出处
《中国当代医药》
2025年第24期14-18,共5页
China Modern Medicine
基金
江西省卫生健康委科技计划项目(20204823)。
关键词
良性前列腺增生
经尿道前列腺等离子电切术
失血量
预测模型
Benign prostatic hyperplasia
Transurethral plasma kinetic prostatectomy of the prostate
Blood loss
Prediction model
