前列腺增生并发急性尿潴留患者撤管试验成功率的相关因素研究

Study on the factors of affecting the success rate of trial without catheter in patients with benign prostatic hyperplasia complicated with acute urinary retention

目的:探讨前列腺增生并发急性尿潴留患者撤管试验成功率的相关因素。方法:选择2020年1月至2021年10月在本院收治的78例因前列腺增生发生首次急性尿潴留患者的临床资料,患者给予常规留置导尿管,同时给予口服坦索罗辛0.2 mg/d,3 d后行撤管试验。根据撤管试验是否成功将患者分为成功组(29例)和失败组(49例)。观察分析比较两组患者的年龄、导尿后的残余尿量(RV)、前列腺体积(PV)、前列腺突入膀胱距离(IPP)。结果:成功组患者的年龄、PV、RV小于失败组,而IPP≤5 mm例数多于失败组,差异均有统计学意义(均P<0.05)。二分类logistic回归分析结果显示,年龄、PV、IPP是撤管试验失败的预测因子(均P<0.05)。年龄、PV、IPP的曲线下面积分别为0.79、0.88、0.80,其最佳截点分别是71.5岁(灵敏度75.5%,特异度86.2%)、58.0 mL(灵敏度79.6%,特异度93.1%)、0.75 mm(灵敏度63.3%,特异度86.2%)。结论:年龄、PV、IPP是撤管试验失败的预测因子,年龄>72岁、PV>58 mL、IPP>10 mm的患者行撤管试验的成功率较低,建议行手术治疗。

Objective To explore the related factors affecting the success rate of trial without catheter in patients with benign prostatic hyperplasia complicated with acute urinary retention.Methods From January 2020 to October 2021,78 patients with the first acute urinary retention in the outpatient department of our hospital were selected,and they were given routine indwelling catheterization and oral administration of tamsulosin 0.2 mg/d.After 3 days,a trial without catheter was performed.The patients were divided into a successful group(29 cases)and a failed group(49 cases)according to the success of the catheterization test.The age,residual urine volume after catheterization(RV),prostate volume(PV),and prostatic penetration distance(IPP)were observed.Results The age,PV and RV of patients in the successful group were smaller than those in the failed group,while the number of patients with IPP≤5 mm was more than that in the failed group,and the differences were statistically significant(all P<0.05).Binary logistic regression analysis showed that age,PV and IPP were the predictors of the failure of the withdrawal test(all P<0.05).The areas under the curve of age,PV and IPP were 0.79,0.88 and 0.80,respectively,and the optimal cut-off points were 71.5 years(sensitivity 75.5%,specificity 86.2%),58.0 mL(sensitivity 79.6%,specificity 93.1%)and 0.75 mm(sensitivity 63.3%,specificity 86.2%),respectively.Conclusions Age,PV,and IPP are predictors of failure of trial without catheter.The success rate of trial without catheter is low if the age is older than 72 years,the PV is larger than 58 mL,and the IPP is larger than 10 mm,and surgical treatment is recommended.