老年前列腺增生患者经尿道等离子双极电切术后尿道狭窄发生的风险因素分析

Analysis of risk factors of urethral stricture in elderly patients with prostatic hyperplasia after transurethral plasma kinetic re-section of prostate

中文关键词: 老年  前列腺增生  尿道等离子双极电切术  尿道狭窄  前列腺体积  手术时间

英文关键词: elderly  prostatic hyperplasia  transurethral plasma kinetic resection of prostate  urethral stricture  prostate volume  surgical time

中文摘要:

      目的 探究老年经尿道等离子双极电切术(PKRP)术后患者尿道狭窄发生的风险因素,为制定科学有效的防治对策提供依据.方法 回顾性选取2020 年4 月—2022 年10 月在连云港市第二人民医院住院部进行PKRP治疗的老年前列腺增生患者260 例,收集患者临床资料,随访12 个月,统计患者术后尿道狭窄发生情况,采用二元Logistic回归方法分析患者术后发生尿道狭窄的风险因素.结果 260 例老年前列腺增生患者,PKRP术后发生尿道狭窄104 例,发生率为40.00%;单因素分析结果显示,术前导尿、术前合并尿路感染、前列腺体积、手术时间、术后留置导尿管时间与老年患者PKRP术后发生尿道狭窄有关(P＜0.05);二元Logistics回归分析显示,术前合并尿路感染(OR =1.740)、前列腺体积cut-off值≥80 mL(OR =2.042)、手术时间cut-off值≥60 min(OR =1.939)、术后留置导尿管时间cut-off值≥8 d(OR =1.697)是老年PKRP术后发生尿道狭窄的独立风险因素(P＜0.05).结论 术前合并尿路感染、前列腺体积≥80 mL、手术时间≥60 min、术后留置导尿管时间≥8d可能是增加PKRP术后发生尿道狭窄的危险因素,临床上应重点关注,采取针对性的防治措施.

英文摘要:

      Objective To explore the risk factors of urethral stricture in elderly patients after transurethral plasma kinetic resection of prostate(PKRP),and provide a basis for scientific and effective prevention and treatment countermeasures.Methods 260 elderly patients with prostatic hyperplasia undergoing PKRP in Second People's Hospital of Lianyungang City from April 2020 to October 2022 were retrospectively selected.Their clinical data were collected.They were followed up for 12 months and the incidence of postoperative urethral stricture was analyzed.The risk factors of postoperative urethral stricture were analyzed by binary Logistics regression.Results Among 260 elderly patients with prostatic hyperplasia,104 ones devel-oped urethral stricture after PKRP,with an incidence of 40.00%.The results of univariate analysis showed that preoperative urinary catheterization,preoperative concurrent urinary tract infection,prostate volume,surgical time,and postoperative in-dwelling catheter time were related to the occurrence of urethral stricture in elderly patientsafter PKRPsurgery(P＜0.05).Bi-nary Logistic regression analysis showed that preoperative concurrent urinary tract infection(OR =1.740),prostate volume cut-off value≥80 mL(OR =2.042),surgical time cut-off value≥60 min(OR =1.939),and postoperative indwelling catheter time value≥8 d(OR =1.697)were independent risk factors for postoperative urethral stricture in elderly patients un-dergoing PKRP(P＜0.05).Conclusion Preoperative concurrent urinary tract infection,prostate volume≥80 mL,surgical time≥60 min and postoperative indwelling catheter time≥8 d may be risk factors for urethral stricture after PKRP.In clinical practice,they should be given special attention and targeted prevention and treatment measures should be taken.