良性前列腺增生症患者术后附睾炎发生状况及其影响因素

The Occurrence and Influencing Factors of Postoperative Epididymitis in Patients with Benign Prostatic Hyperplasia

目的观察良性前列腺增生症患者术后附睾炎发生状况,并分析其中影响因素。方法收集2018年2月至2020年4月在灵宝市第一人民医院接受经尿道前列腺电切术的128例良性前列腺增生患者病例资料进行回顾性分析,查阅病例资料,统计患者术后1个月内附睾炎发生情况,以随访期间附睾炎发生情况定义分组,将发生附睾炎患者纳入发生组,未发生附睾炎患者纳入未发生组。根据研究目的,统计患者一般临床资料,重点分析良性前列腺增生症患者术后发生附睾炎的影响因素。结果本研究中128例患者,术后12例发生附睾炎,占9.38%。两组年龄、BMI、合并症、抗生素使用时间、术前行前列腺穿刺、术前t-PSA、导尿管留置时间、IPSS评分、既往手术史、术前ASA分级、血清T、E2相比较,差异无统计学意义(P>0.05);发生组前列腺体积大于未发生组,手术时间、术后置管时间长于未发生组,合并糖尿病患者占比多于未发生组,差异有统计学意义(P<0.05)。Logistic回归分析结果显示,前列腺体积≥80 mL(β=1.958,OR=7.083,95%CI:1.485~33.793)、手术时间>90 min(β=2.176,OR=8.810,95%CI:1.843~42.120)、术后置管时间>3 d(β=1.412,OR=4.105,95%CI:1.163~14.492)、合并糖尿病(β=1.678,OR=5.357,95%CI:1.124~25.526)均能够增加良性前列腺增生症患者术后附睾炎发生风险,差异有统计学意义(P<0.05)。结论良性前列腺增生症患者术后附睾炎的发生率较低,前列腺体积≥80 mL、手术时间>90 min、术后置管时间>3 d、合并糖尿病是导致良性前列腺增生症患者术后发生附睾炎的危险因素。

Objective To observe the incidence of epididymitis in patients with benign prostatic hyperplasia(BPH)after surgery and analyze the influencing factors.Methods The data of 128 patients with benign prostatic hyperplasia who underwent transurethral resection of the prostate at the First People’s Hospital of Lingbao from February 2018 to April 2020 were retrospectively analyzed.The case data were reviewed,and the incidence of epididymitis within 1 month after operation was counted.Groups were defined by the occurrence of epididymitis during follow-up,the patients with epididymitis were included in the occurrence group,and the patients without epididymitis were included in the non occurrence group.According to the purpose of the study,the general clinical data of patients were statistically analyzed,with a focus on the influencing factors of postoperative epididymitis in patients with benign prostatic hyperplasia.Results Of the 128 patients in this study,12(9.38%)developed epididymitis after surgery.There was no statistical significant difference in age,body mass index(BMI),hypertension,hyperlipidemia,antibiotic application time,preoperative prostate puncture,preoperative total prostate specific antigen(t-PSA),preoperative American Society of Anesthesiologists(ASA)classification,postoperative indwelling catheter time,international prostate symptom(IPSS)score,previous surgical history,serum testosterone(T)and estradiol(E2)between the two groups(P>0.05).The volume of prostate in the occurrence group was larger than that in the non occurrence group,the time of tube insertion and operation after operation was longer than that in the non occurrence group,and the proportion of patients with diabetes was more than that in the non occurrence group,with a statistical significant difference(P<0.05).Logistic regression analysis showed that prostate volume≥80 mL(β=1.958,OR=7.083,95%CI:1.485~33.793),operation time>90 min(β=2.176,OR=8.810,95%CI:1.843~42.120),postoperative catheterization time>3 d(β=1.412,OR=4.105,95%CI:1.163~14.492),combined with diabetes(β=1.678,OR=5.357,95%CI:1.124~25.526)could increase the risk of postoperative epididymitis in patients with benign prostatic hyperplasia,with a statistical significant difference(P<0.05).Conclusion The incidence of postoperative epididymitis in patients with benign prostatic hyperplasia is relatively low.Prostate volume≥80mL,operation time>90 min,postoperative catheterization time>3 days,and diabetes are risk factors for postoperative epididymitis in patients with benign prostatic hyperplasia.