老年良性前列腺增生合并混合痔患者术后尿潴留的影响因素分析

Analysis of influencing factors of postoperative urinary retention in elderly patients with benign prostatic hyperplasia compli-cated with mixed hemorrhoids

中文关键词: 老年  良性前列腺增生  混合痔  尿潴留  影响因素

英文关键词: elderly  benign prostatic hyperplasia  mixed hemorrhoid  urinary retention  influencing factor

中文摘要:

      目的 分析老年良性前列腺增生(BPH)合并混合痔患者术后尿潴留的影响因素.方法 选取 2020 年 1 月—2023 年5 月安庆市中医医院收治的194 例老年BPH合并混合痔患者.根据患者外剥内扎术术后是否发生尿潴留分为尿潴留组(n =72)和非尿潴留组(n =122).比较2 组的临床资料、术后24h视觉模拟评分法(VAS)及术后 24h焦虑自评量表(SAS)评分.分析患者术后尿潴留的影响因素,构建术后尿潴留的人工神经网络模型,并对模型的效能进行验证.结果 与非尿潴留组比较,尿潴留组便秘者和镇痛泵使用者较多,术前空腹血糖(FBG)水平较高,手术时间较长,静脉补液量较大,术后24 h VAS和SAS评分较高(P＜0.05).多因素分析结果显示,便秘、术前FBG升高、手术时间长、静脉补液量大、术后使用镇痛泵、术后24 h VAS和术后24 h SAS评分升高均为老年BPH合并混合痔患者术后尿潴留的独立危险因素(P＜0.05).人工神经网络预测模型的区分度良好,该模型的曲线下面积为 0.733(95%CI:0.663～0.804,P＜0.001);灵敏度为83.33%(60/72),特异度为85.25%(104/122).结论 便秘、术前FBG升高、手术时间长、静脉补液量大、术后使用镇痛泵、术后24 h VAS和术后24 h SAS评分升高可能是老年BPH合并混合痔患者术后尿潴留的影响因素.

英文摘要:

      Objective To analyze the influencing factors of postoperative urinary retention in elderly patients with be? nign prostatic hyperplasia (BPH) complicated with mixed hemorrhoids. Methods 194 elderly patients with BPH complicated with mixed hemorrhoids admitted to Traditional Chinese Medicine Hospital of Anqing City from January 2020 to May 2023 were selected. They were divided into urinary retention group (n = 72) and non?urinary retention group (n = 122) according to whether urinary retention occurred after external stripping and internal ligation. The clinical data, postoperative 24?hour visual analogue scale (VAS) score and postoperative 24?hour self?rating anxiety scale (SAS) score were compared between the two groups. The influencing factors of postoperative urinary retention were analyzed, the artificial neural network model of postop? erative urinary retention was constructed, and the effectiveness of the model was verified. Results Compared with the non?uri? nary retention group, the urinary retention group had more constipation patients and analgesic pump users, higher preoperative fasting blood glucose (FBG) level, longer operation time, larger intravenous fluid replacement, and higher postoperative 24 h VAS and SAS scores (P <0. 05). Multivariate analysis showed that constipation, increased preoperative FBG level, long oper? ation time, large amount of intravenous fluid replacement, postoperative use of analgesia pump, postoperative 24 h VAS and SAS scores were all independent risk factors for postoperative urinary retention in elderly patients with BPH complicated with hemorrhoids (P <0. 05). The discriminability of the artificial neural network prediction model was good. The area under the curve of the model was 0. 733 (95% CI: 0. 663?0. 804, P < 0. 001), sensitivity was 83. 33% (60/ 72), and specificity was 85. 25% (104/ 122). Conclusion Constipation, increased preoperative FBG level, long operation time, large amount of in? travenous fluid replacement, postoperative use of analgesic pump, increased postoperative 24 h VAS and SAS score may be the influential factors of postoperative urinary retention in elderly patients with BPH complicated with mixed hemorrhea.