肛门部良性疾病术后尿潴留的危险因素

Risk factors for postoperative urinary retention in benign anal diseases

目的探讨肛门部良性疾病术后尿潴留的危险因素及发生率。方法收集2017年12月~2018年12月于成都上锦南府医院行肛门部良性疾病手术患者1870例的病例资料。根据患者术后是否发生尿潴留将病例资料分为尿潴留组和非尿潴留组。使用SAS9.4软件对收集的病例资料进行统计分析,计算肛门部良性疾病术后尿潴留的发生率,单因素Logistic回归分析筛选出术后尿潴留的危险因素,多因素Logistic回归分析确定术后尿潴留的独立危险因素。结果术后尿潴留的发生率为31.01%;女性患者术后尿潴留发生率高于男性患者(P<0.05);年龄>60岁的患者术后尿潴留发生率高于年龄<60岁的患者(P<0.05);已婚患者术后尿潴留发生率高于未婚患者(P<0.05);病房手术室内针刺麻醉(腰俞穴麻醉)术后尿潴留发生率低于全身麻醉、骶管麻醉、全麻联合骶管麻醉(P<0.05),后3种麻醉方式术后尿潴留发生率差异无统计学意义(P>0.05);不同类型肛门部良性疾病术后尿潴留的发病率不同,混合痔术后尿潴留的发病率最高,内痔术后尿潴留的发病率最低(P<0.05);尿潴留组患者的住院时间大于非尿潴留组患者(P<0.05)。结论肛门部良性疾病术后尿潴留是多因素共同作用的结果。危险因素有女性、年龄>60岁、已婚、疾病种类、全身麻醉、骶管麻醉以及全麻联合骶管麻醉。其中女性、全身麻醉、骶管麻醉及全麻联合骶管麻醉为术后尿潴留的独立危险因素。

Objective To investigate the risk factors and incidence of postoperative urinary retention in benign anal diseases.Methods The medical data of patients who underwent surgery for benign anal diseases in Chengdu Shangjin Nanfu Hospital from December 2017 to December 2018 was collected by consulted the electronic medical record system of the hospital.According to whether the patients had postoperative urinary retention,the medical data were divided into the urinary retention group and the non-urinary retention group.SAS9.4 software was used to statistical analysis the collected medical data to calculate the incidence of postoperative urinary retention in benign anal diseases.Single-factor Logistic regression analysis was used to select the related risk factors,and multi-factor Logistic regression analysis was used to determine the independent risk factors of postoperative urinary retention in benign anal diseases.Results A total of 1870 patients who underwent surgery for benign anal diseases were included in the study.The incidence of postoperative urinary retention was 31.01%.The incidence of postoperative urinary retention was higher in female patients than in male patients(P<0.05).The incidence of postoperative urinary retention was higher in patients older than 60 years than in patients younger than 60 years(P<0.05).The incidence of postoperative urinary retention was higher in married patients than in unmarried patients(P<0.05).The incidence of postoperative urinary retention after acupuncture anesthesia(Yaoshu point anesthesia)in the operating room of ward was lower than general anesthesia,caudal anesthesia and general anesthesia combined with caudal anesthesia(P<0.05).There was no statistical difference in the incidence of postoperative urinary retention among the last three anesthesia methods(P>0.05).The incidence of postoperative urinary retention was different in different types of benign anal diseases and the incidence of postoperative urinary retention was the highest in mixed hemorrhoids and the lowest in internal hemorrhoids(P<0.05).The length of hospital stay in the urinary retention group was(8.8±3.0)days,which was longer than that in the non-urinary retention group(8.4±2.9 days)(P<0.05).Conclusion Postoperative urinary retention in benign anal diseases is the result of multiple factors.Risk factors were female,age over 60,married,type of disease,general anesthesia,caudal anesthesia,and general anesthesia combined with caudal anesthesia.Female,general anesthesia,caudal anesthesia,and general anesthesia combined with caudal anesthesia were independent risk factors for postoperative urinary retention.