摘要
目的探讨经尿道前列腺电切术（TURP）术后出现持续尿频的危险因素。
方法回顾性分析2014年1月至2015年6月收治的119例TURP术后患者的临床资料。年龄（72.1±2.3）岁。伴高血压病15例，糖尿病23例，心脏疾病6例。119例术前IPSS评分（22.1±5.9）分，其中储尿期评分（10.2±1.8）分，排尿期评分（11.8±4.7）分。每日排尿次数（10.8±2.6）次，夜尿次数（3.8±0.8）次。B超检查：残余尿量（38.1±9.1）ml，前列腺体积（34.1±4.2）ml。术前最大尿流率（8.8±3.9）ml/s。最大尿流率逼尿肌压力（43.9±14.1）cmH2O（1 cmH2O＝0.098 kPa），最大逼尿肌压力（99.7±12.2）cmH2O，有效膀胱容量（217.5±14.8）ml。40例（33.6%）膀胱收缩力减弱，36例（30.2%）膀胱逼尿肌活动过度。根据术后是否出现持续尿频，将患者分为尿频阳性组和尿频阴性组。比较两组患者上述指标的差异并进行单因素分析，对有统计学意义的指标进行Logistic回归多因素分析。
结果119例患者中，尿频阳性组21例，尿频阴性组98例。单因素分析结果显示，年龄、IPSS评分、术前储尿期评分、最大尿流率逼尿肌压力、最大逼尿肌压力、有效膀胱容量、膀胱收缩力减弱、术前膀胱逼尿肌活动过度是影响术后尿频的重要指标（均P〈0.05）。多因素分析结果显示，年龄大（OR＝3.842，P＝0.021）、IPSS总分高（OR＝5.109，P＝0.011）、最大逼尿肌压力低（OR＝3.477，P＝0.039）、有效膀胱容量低（OR＝4.051，P＝0.017）、膀胱逼尿肌活动过度（OR＝3.662，P＝0.025）是TURP术后出现尿频的独立危险因素。
结论年龄大、术前IPSS总分高、最大逼尿肌压力低、有效膀胱容量低、膀胱逼尿肌活动过度是TURP术后出现尿频的独立危险因素。
ObjectiveTo discuss the risk of factors influencing persistent frequency after transurethral resection of the prostate （TURP）.
MethodsThe clinical data of 119 post-TURP patients treated from January 2014 to June 2015 was retrospectively analyzed. The age was （72.1±2.3）years old. There were 15 cases with hypertension, 23 cases with diabetes and 6 cases with heart disease. The preoperative IPSS score of 119 cases was （22.1±5.9） points, with （10.2±1.8） points in urinary storage period and （11.8±4.7） points in urination period. Urination frequency was （10.8±2.6） times per day and there were （3.8±0.8） times of nocturnal urination. B-ultrasound： residual urine volume was （38.1±9.1） ml and prostate volume was （34.1±4.2） ml. Preoperative maximum urine flow rate was （8.8±3.9） ml/s. The detrusor pressure at maximum urinary flow rate was （43.9±14.1） cm H2O （1 cmH2O = 0.098 kPa）, maximum detrusor pressure was （99.7±12.2） cmH2O and effective bladder volume was （217.5±14.8） ml. Contraction of bladder weakened in 40 cases （33.6%） and 36 cases （30.2%） had detrusor overactivity. According to whether continuous urinary frequency was developed, the patients were divided into frequency-positive group and frequency-negative group. The differences between the patients in two groups were compared and univariate analysis was performed. A multivariate logistic regression was performed on statistically significant indicators.
ResultsAmong the 119 patients, 21 were frequency-positive and 98 were frequency-negative. Univariate analysis showed that age, IPSS score, preoperative urinary storage score, detrusor pressure at maximum urinary flow rate, maximum detrusor pressure, effective bladder volume, contraction decrease of bladder, preoperative detrusor activity were important indicators affecting the condition of postoperative urinary frequency （all P〈0.05）. Multivariate analysis showed that old age （OR=3.842, P=0.021）, high total IPSS score （OR=5.109, P=0.011）, low maximum detrusor pressure （OR=3.477, P=0.039）, low effective volume of bladder （OR=4.051, P=0.017） and detrusor overactivity （OR=3.662, P=0.025） were independent risk factors for urinary frequency after TURP.
ConclusionsThe age, the high IPSS score before operation, low maximal detrusor pressure, low effective bladder capacity and the bladder detrusor activity could be independent predictive factors of persistent frequency after TURP.
出处
《中华泌尿外科杂志》
CAS
CSCD
北大核心
2018年第1期34-37,共4页
Chinese Journal of Urology
基金
浙江省卫生厅医药课题项目的资助（2016KYA093）
关键词
经尿道前列腺电切术
尿频
危险因素
Transurethral resection of prostate
Persistent frequency
Risk factors
作者简介
通信作者：王伟高，Email：wwg739@163．com
