前列腺电切术后尿频的危险因素研究

Study on Risk Factors of Frequent Urination after Prostatectomy

目的探究患者在进行前列腺电切手术后出现尿频的相关危险因素。方法选取该院2017年1月—2019年10月在该院实施前列腺电切手术的125例患者作为研究资料,根据患者术后观察指标比较进行尿频的单因素分析以及通过Logistic进行多因素分析。结果 125例研究资料中尿频阳性组为22例,尿频阴性组为103例,根据患者术后观察指标比较的尿频单因素分析结果显示,尿频阳性组在患者年龄(75.2±2.8)岁高于阴性组年龄(72.4±3.1)岁,差异有统计学意义(t=4.502,P<0.001);尿频阳性组IPSS评分(25.1±5.8)分高于阴性组IPSS评分(20.3±7.5)分,差异有统计学意义(t=2.924,P<0.05);尿频阳性组储尿期评分(12.3±1.7)分高于阴性组储尿期评分(9.2±2.3)分,差异有统计学意义(t=5.562,P<0.001);阳性组最大尿流率逼尿肌压力(40.8±13.8)cmH2O低于阴性组最大尿流率逼尿肌压力(48.9±14.7)cm H2O,差异有统计学意义(t=2.334,P<0.05);阳性组最大逼尿肌压力(97.2±10.8)cmH2O低于阴性组最大逼尿肌压力(103.6±14.7)cmH2O,差异有统计学意义(t=2.325,P<0.05);阳性组有效膀胱容量(195.7±12.8)mL低于阴性组有效膀胱容量(238.6±19.7)mL,差异有统计学意义(t=9.595,P<0.001);阳性组中膀胱收缩力减弱患者为14例(63.6%)高于阴性组膀胱收缩力减弱患者25例(24.3%),差异有统计学意义(χ^2=11.315,P<0.05);阳性组中膀胱逼尿肌活动过度患者为13例(59.1%)高于阴性组膀胱逼尿肌活动过度患者为25例(24.3%),差异有统计学意义(χ^2=8.742,P<0.05)。将两组患者的观察指标比较分析结果进行逻辑回归多因素分析(Logistics)显示在众多危险因素中:年龄大(OR=3.849,P<0.05)、IPSS高评分(OR=5.114,P<0.05)、最大逼尿肌压力低(OR=3.484,P<0.05)、有效膀胱容量低(OR=4.058,P<0.05)、膀胱逼尿肌活动过度(OR=3.669,P<0.05),均是TURP术后患者主要的危险因素。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。

Objective To explore the related risk factors of frequent urination in patients undergoing prostatectomy.Methods 125 patients who underwent resection of the prostate in our hospital from January 2017 to October 2019 were selected as research data.Univariate analysis of urinary frequency was performed based on comparison of postoperative observation indicators of patients and multivariate analysis was performed by Logistic.Results Of the 125 cases,22 were positive in the urinary frequency group and 103 were in the negative frequency group.According to the comparison of postoperative observations,the urinary frequency positive univariate analysis showed that the frequency of the urinary frequency group was higher than that of the negative patients(75.2±2.8)years old higher than the negative group age(72.4±3.1)years old,the difference was statistically significant(t=4.502,P<0.001);the IPSS score(25.1±5.8)points in the frequent urinary group was higher than that in the negative group(20.3±7.5)points,and the difference was statistically significant(t=2.924,P<0.05);the urine storage score(12.3±1.7)points in the positive urinary group was higher than that in the negative group(9.2±2.3)points,and the difference was statistically significant(t=5.562,P<0.001);The maximum urinary flow rate of the detrusor pressure in the positive group(40.8±13.8)cmH2O was lower than the maximum urinary flow rate of the negative group(48.9±14.7)cmH2O,and the difference was statistically significant(t=2.334,P<0.05);positive maximum detrusor pressure(97.2±10.8)cmH2O in the negative group was lower than the maximum detrusor pressure(103.6±14.7)cmH2O in the negative group,and the difference was statistically significant(t=2.325,P<0.05);the effective bladder volume in the positive group(195.7±12.8)mL,lower than the effective bladder volume of the negative group(238.6±19.7)mL,The difference was statistically significant(t=9.595,P<0.001);14 patients with weakened bladder contractility in the positive group(63.6%)were higher than 25 patients(24.3%)with weakened bladder contractility in the negative group.The difference was statistically significant(χ^2=11.315,P<0.05);13 cases(59.1%)of patients with overactive bladder detrusor activity in the positive group were higher than 25 cases(24.3%)of patients with overactive bladder detrusor activity in the negative group,the difference was statistically significant(χ^2=8.742,P<0.05).Logistic regression multivariate analysis(Logistics)was used to compare and analyze the observational indicators of the two groups of patients.The results were shown in many risk factors:older(OR=3.849,P<0.05),IPSS score higher(OR=5.114,P<0.05),low maximum detrusor pressure(OR=3.484,P<0.05),low effective bladder capacity(OR=4.058,P<0.05),and excessive bladder detrusor activity(OR=3.669,P<0.05),all were main risk factors for patients after TURP.Conclusion Older age,high total preoperative IPSS score,low maximum detrusor pressure,low effective bladder capacity,and excessive bladder detrusor activity are independent risk factors for frequent urination after TURP.