TURP术后继发性出血的危险因素Logistic回归分析

Logistic regression analysis on risk factors of secondary hemorrhage after TURP

目的:探讨经尿道前列腺电切(TURP)术后发生继发性出血的相关危险因素。方法:回顾性分析2011年9月~2014年8月339例前列腺增生症(BPH)患者行TURP的临床资料,对可能影响术后发生继发性出血的相关因素进行单因素及多因素Logistic回归分析。结果:339例BPH患者TURP术后发生继发性出血31例,发生率9.14%;单因素分析显示前列腺体积大、合并精尿病、合并高血压、术前1周内并发尿路感染、术前1周内留置尿管、未使用硬膜外镇痛泵者术后出血率较高,分别为14.04%,29.17%,12.99%,17.76%,13.91%,22.03%,差异有统计学意义(P<0.05或0.01);多因素Logistic回归分析显示,前列腺体积(OR=4.14),术前1周内并发尿路感染(OR=2.80)、合并糖尿病(OR=4.81)是术后继发性出血的独立危险因素,使用硬膜外镇痛泵(OR=0.46)是保护因素。结论:前列腺体积大、术前1周内并发尿路感染、合并糖尿病使TURP术后继发性出血的风险增加,使用硬膜外镇痛泵能降低TURP术后继发性出血的风险。

Objective:To investigate the risk factors of secondary hemorrhage after transurethral resection of the prostate(TURP).Methods:The clinical data of 339 patients who underwent TURP were retrospectively analyzed.The related factors of secondary hemorrhage after TURP were analyzed using multivariate Logistic regression analysis.Results:Secondary hemorrhage occurred in 31 cavses of total 339 patients,with the incidence of 9.14%.The univariate analysis showed that increase of hemorrhage incidence was significantly correlated with a large volume of prostate,diabetes,hypertension,urinary tract infection within 1 week preoperatively,indwelling catheters within 1week preoperatively and no using of epidural analgesia pump postoperatively.The rates were 14.04%,29.17%,12.99%,17.76%,13.91%and 22.03%,respectively.The differences were statistically significant(P<0.05 or0.01).Multivariate Logistic regression analysis showed that the volume of the prostate(OR = 4.14),urinary tract infection within 1 week preoperatively(OR=2.80) and diabetes mellitus(OR = 4.81) were independent risk factors of secondary hemorrhage after TURP and the use of epidural analgesia pump(OR=0.46) was a protective factor.Conclusions:A large volume of prostate,urinary tract infection within 1 week preoperatively and diabetes increase the risk of the secondary hemorrhage after TURP,and the use of epidural analgesia pump can reduce the risk of secondary hemorrhage.