良性前列腺增生老年患者电切术后排尿相关并发症的危险因素分析

Risk factors of urination related complications in elderly patients with benign prostatic hyperplasia after electrocision

目的 探讨并分析良性前列腺增生(BPH)老年患者电切术后排尿相关的并发症,并分析其的危险因素。方法 选取2020年1月至2022年1月天长市中医院收治的100例行电切术的BPH老年患者作为研究对象。根据术后有无并发症分为并发症组(n=37)和无并发症组(n=63);采用单因素分析电切术后排尿相关并发症发生的影响因素,采用多元Logistic回归分析影响BPH老年患者电切术后排尿相关并发症的独立危险因素。结果 100例中有37例发生排尿相关并发症(并发症组,n=37),其中尿失禁占43.24%(16/37),尿潴留占32.43%(12/37),排尿困难占24.32%(9/37)。并发症组与无并发症组在合并糖尿病、术后尿管导管留置时间、手术时间、前列腺体积、逼尿肌功能、合并尿路感染及膀胱颈纤维化等方面比较,差异具有统计学意义(P<0.05)。Logistic回归分析显示,术后尿管导管留置时间≥7d(OR=2.962)、手术时间≥1h(OR=2.869)、有膀胱颈纤维化(OR=2.622)、逼尿肌功能不稳定(OR=2.617)均为影响BPH老年患者电切术后排尿相关并发症发生的独立危险因素(P<0.05)。结论 BPH老年患者电切术后易发生排尿相关并发症,以尿失禁、尿潴留及排尿困难为主。临床应重点关注术后尿管导管留置时间≥7d、手术时间≥1h、有膀胱颈纤维化及逼尿肌功能不稳定的老年患者,并积极采取有效的措施预防术后排尿相关并发症的发生风险。

Objective To explore and analyze urination related complications in elderly patients with benign prostatic hyperplasia(BPH) after electrocision,and analyze their risk factors.Methods A total of 100 elderly patients with BPH undergoing electrocision in Tianchang Hospital of Traditional Chinese Medicine between January 2020 and January 2022 were enrolled.According to presence or absence of postoperative complications,they were divided into complication group(n=37) and non-complication group(n=63).Univariate analysis was used to analyze the influencing factors of urination related complications after electrocision,and multivariate Logistic regression was used to analyze the independent risk factors of urination related complications after electrocision in elderly patients with BPH.Results In the 100 cases with BPH after electrocision,the incidence of urination related complications was 37.00%(37/100),among which urinary incontinence accounted for 43.24%(16/37),urinary retention accounted for 32.43%(12/37),and dysuria accounted for 24.32%(9/37).There were significant differences between complication group and non-complication group in diabetes mellitus,postoperative indwelling time of urinary catheter,operation time,prostate volume,detrusor function,urinary tract infection and bladder neck fibrosis(P<0.05).Logistic regression analysis showed that postoperative indwelling time of urinary catheter ≥7 d(OR=2.962),operation time ≥1 h(OR=2.869),bladder neck fibrosis(OR=2.622) and unstable detrusor function(OR=2.617) were independent risk factors of urination related complications(P<0.05).Conclusions Elderly patients with BPH after electrocision are prone to urination related complications,mainly on urinary incontinence,urinary retention and dysuria.Clinically,attentions should be paid to elderly patients with postoperative indwelling time of urinary catheter ≥7 d,operation time ≥1 h,bladder neck fibrosis and unstable detrusor function,and effective measures should be actively taken to prevent postoperative risk of urination related complications.