经尿道前列腺电切术治疗梗阻性膀胱顺应性下降患者的效果及影响因素分析

Effect and influencing factors of TURP in patients with decreased bladder compliance by obstruction

目的探讨经尿道前列腺电切术(TURP)治疗良性前列腺增生(BPH)引起的梗阻性膀胱顺应性下降患者的手术效果及相关影响因素分析。方法回顾性分析2016年10月至2019年11月天津医科大学第二医院及天津医科大学中新生态城医院收治的98例BPH引起膀胱出口梗阻(BOO)且存在膀胱顺应性下降患者的临床资料。根据术后6个月的手术效果将其分为优良组、满意组、不满意组、无效组,评估手术治疗的有效率,利用单因素及多因素logistic回归分析影响手术效果的相关因素。结果手术的临床总有效率(优良组+满意组)为77.6%(76/98)。所有患者术后3个月的IPSS评分、Q_(max)、膀胱顺应性显著优于手术前(P<0.05),术后6个月的膀胱顺应性、Pdet-max优于术后3个月(P<0.05)。单因素分析显示,手术效果与患者年龄、病程时间、术前Pdet-max具有相关性(P<0.05)。多因素logistic回归分析显示,年龄、病程、术前Pdet-max是影响手术效果的危险因素(P<0.05)。结论TURP治疗BPH引起的梗阻性膀胱顺应性下降患者大多可获得良好的手术效果,年龄、病程时间、术前Pdet-max是影响患者手术效果的主要危险因素。

Objective To investigate the effect of transurethral resection of prostate(TL RP)and the influence factors in patients with decreased bladder compliance caused by benign prostate hy-perplasia(BPH).Methods Clinical data of 98 patients with RPH-induced bladder outlet obstruction(BOO)and decreased bladder compliance admitted to the second hospital of Tianjin medical university and Sino-Singapore eco-city hospital of Tianjin medical university from October 2016 to November 2019 were retrospectively analyzed.According to the operative effect at 6 months after operation,the patients were divided into excellent group,satisfactory group,unsatisfactory group and ineffective group.The effective rate of surgical treatment was evaluated,and the relevant factors affecting the operative effect were analyzed by univariate and multivariate logistic regression.Results The total clinical effective rate(excellent group+satisfactory group)was 77.6%(76/98).The IPSS score,Q_(max) and bladder compliance of all patients at 3 months after surgery were significantly better than those before surgery(P<0.05),and bladder compliance and Pdet-max at 6 months after surgery were better than those at 3 months after surgery(P<0.05).Univariate analysis showed that the operative effect was correlated with age,duration of disease and preoperative Pdet-max(P<0.05).Multivariate logistic regression analysis showed that age,course of disease and preoperative Pdet-max were the risk factors affecting the surgical effect(P<0.05).Conclusions Most patients with BPH-induced decreased compliance of obstructive bladder can obtain good surgical results by TURP,and age,duration of disease and preoperative Pdet-max are the main risk factors affecting the surgical results of patients.