经尿道前列腺电切术后前尿道狭窄相关因素分析

目的 分析经尿道前列腺电切术(TURP)患者术后前尿道狭窄的发病情况及其围手术期相关因素.方法 回顾性分析426例行TURP的良性前列腺增生患者的临床资料,包括年龄、术前合并膀胱结石、术前合并2型糖尿病、术前合并高血压、术前尿路感染、术前是否留置尿管、手术医师、手术时间、术中使用电切镜型号、术中使用石蜡油润滑、术后尿道牵引时间、术后尿路感染、术后留置尿管时间,将可能与术后出现前尿道狭窄的相关因素进行多因素非条件Logistic回归分析.结果 23例患者术后出现前尿道狭窄,发生率为5.40％ (23/426).进行多因素非条件Logistic回归分析显示,术前尿路感染OR=4.630,95％ CI(1.386 ～ 15.468),P=0.013]、术中使用电切镜型号OR=2.887,95％ CI(1.100 ～7.579),P=0.031]、术后尿路感染OR =6.117,95％ CI(2.088 ～ 17.925),P=0.001]、术后尿道牵引时间OR=4.083,95％ CI(1.521～ 10.961),P=0.005]、术后留置尿管时间OR=4.388,95％ CI(1.533 ～ 12.564),P=0.006]进入回归方程.结论 术前尿路感染、术中使用电切镜型号、术后尿路感染、术后尿道牵引时间、术后留置尿管时间是TURP术后患者发生前尿道狭窄的相关因素.

Relevant factors analysis of postoperative anterior urethral stricture in transurethral resection of the prostate

Objective To investigate the incidence and risk factors of postoperative anterior urethral stricture in transurethral resection of the prostate (TURP).Methods A retrospective study reviewing the medical records of the patients who received TURP were performed.The possible relevant factors of postoperative anterior urethral stricture were recorded.The contents included age,preoperative combined with bladder stones,preoperative with type 2 diabetes,preoperative combined with hypertension,preoperative urinary tract infection,preoperative indwelling catheter,surgeons,surgical time,intraoperative used resectoscopy size,intraoperative used paraffin oil lubrication,postoperative urethral traction time,postoperative urinary tract infection,postoperative indwelling catheter time.Logistic regression analysis was done to rank the relative risk of potential variables.Results Prevalence of postoperative anterior urethral stricture in our hospital was 5.40％ (23/426).Univariate and Logistic regression analysis revealed that the risk factors of postoperative urethral stricture in TURP were preoperative urinary tract infection OR =4.630,95 ％ CI (1.386-15.468),P =0.013],intraoperative used resectoscopy size OR =2.887,95 ％ CI (1.100-7.579),P =0.031],postoperative urinary tract infection OR =6.117,95％ CI(2.088-17.925),P =0.001],postoperative urethral traction time OR =4.083,95％ CI(1.521-10.961),P =0.005],postoperative indwelling catheter timeOR =4.388,95％ CI (1.533-12.564),P =0.006].Conclusions Preoperative urinary tract infection,intraoperative uses resectoscopy size,postoperative urinary tract infection,postoperative urethral traction time and postoperative indwelling catheter time are the relevant factors of postoperative urethral stricture in patients with TURP.