中老年人行前列腺癌根治术后发生尿失禁的高危因素分析

Analysis of high-risk factors for urinary incontinence after radical prostatectomy in middle-aged and elderly patients

目的分析中老年人行前列腺癌根治术后发生尿失禁的高危险因素.方法选取2014年至2020年福建省内5家综合性医院泌尿外科行前列腺癌根治术的626例中老年人患者作为研究对象,根据入组患者术后是否发生尿失禁将患者分为对照组(术后未发生尿失禁者,526例)和观察组(术后并发尿失禁者,100例).分析两组患者的一般资料、临床资料、手术治疗、护理资料的各指标间差异,采用多因素logistic分析前列腺癌根治术后发生尿失禁的高危因素.结果共100例患者术后发生尿失禁,尿失禁发生率为15.97%.中老年人行前列腺癌根治术患者术后发生尿失禁与年龄、体重指数(BMI)、术前前列腺增生、术前膀胱功能、前列腺癌病理分期、既往尿道前列腺手术史、放疗史、手术者的手术台数、手术损伤括约肌、术中神经损伤、术后康复锻炼依从性均有相关性(均P<0.05).多因素logistic结果分析显示,年龄≥75岁、前列腺增生、术前膀胱失代偿、手术损伤括约肌、术中神经损伤、既往有尿道前列腺手术史、术后康复锻炼依从性低均为中老年人行前列腺癌根治术患者术后发生尿失禁的独立危险因素(均P<0.05).结论中老年人行前列腺癌根治术后发生尿失禁的概率高,影响术后尿失禁危险因素主要是患者病情、手术质量,临床制定围手术期治疗和护理方案应充分考虑其危险因素,制定针对性措施预防尿失禁,提高患者术后病情康复及生活质量水平.

Objective To analyze the high risk factors of urinary incontinence after radical prostatectomy for middle-aged and elderly patients.Methods From 2014 to 2020,626 cases of elderly patients with prostate cancer who underwent radical prostatectomy in urology department of five comprehensive hospitals in Fujian province were selected as the research object.Patients were divided into control group(526 cases without postoperative urinary incontinence)and observation group(100 cases with postoperative urinary incontinence)according to the occurrence of postoperative urinary incontinence.The differences of individual data,clinical data,surgical treatment and nursing data between the two groups was analyzed,and multivariate logistic analysis was used to analyze the risk factors of u-rinary incontinence after radical prostatectomy.Results A total of 100 patients were complicated with postoperative urinary incontinence,and the incidence of urinary incontinence was 15.97%.Elderly pedestrian urinary incontinence postoperatively in patients with prostate cancer treated with age,body mass index(BMI),preoperative prostate hyperplasia of prostate and bladder function preoperatively,pathological staging,history of urethra prostate surgery,radiotherapy,surgery surgical sets,surgical injury of sphincter,intraoperative nerve injury,postoperative rehabilitation exercise adherence have correlation(all P<0.05).Multi-factor logistic analysis showed that age≥75 years old,hyperplasia of prostate and sphincter preoperative bladder decompensation,surgical injury of sphincter,intraoperative nerve injury,has a history of urethra prostate surgery,postoperative rehabilitation exercise adherence low are middle-aged and old patients with prostate cancer radical footbridge independent risk factors for postoperative urinary incontinence(all P<0.05).Conclusions The rate of urinary incontinence after radical surgery for middle-aged and elderly prostate cancer patients is high,and the risk factors affecting postoperative incontinence are mainly the patientcondition and the quality of surgery.The clinical formulation of perioperative treatment and care plans should fully consider the risk factors,which should formulate targeted measures to prevent incontinence to improve the patient^recovery and quality of life after surgery.