经尿道前列腺等离子剜除术预后的影响因素分析

Analysis of the risk factors of poor prognosis of the operation of plasma kinetic enucleation of the prostate

杨坤儒 ¹李小滨 ¹杨健 ¹曾柯 ¹黄贵书 ¹黄俊 ¹尹素素²

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作者信息

1. 四川省自贡市第一人民医院泌尿外科,四川自贡 643000
2. 四川卫生康复职业学院临床医技学院,四川自贡 643000
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摘要

目的研究经尿道前列腺等离子剜除术(PKEP)预后的影响因素.方法选取2020年5月至2022年1月在自贡市第一人民医院行PKEP手术的148例良性前列腺增生患者作为研究对象,根据术后3个月患者的国际前列腺症状评分(IPSS)分为两组,将IPSS≥8分的患者纳入术后预后不佳组(59例),将IPSS≤7分的患者纳入预后良好组(89例),收集并统计两组患者间年龄、体重指数、基础疾病、术前IPSS评分、前列腺体积、术中剜除时间、出血量等数据,并将差异有统计学意义的指标进行二元logistic回归分析.结果术后3个月预后良好组的IPSS为(4.93±1.16)分,低于预后不佳组的(10.81±2.18)分,差异有统计学意义(P＜0.05).两组的游离前列腺特异性抗原(fPSA)、体重指数(BMI)、前列腺体积(PV)、剜除的前列腺质量、术前IPSS评分、剜除时间、出血量、最大尿流率(Qmax)和糖尿病发生情况相比较,差异有统计学意义(P＜0.05);糖尿病(β=0.516,OR=1.236,95％CI=1.106～2.539)、剜除时间(β=0.019,OR=1.023,95％CI=1.010～1.037)是前列腺剜除术后预后不佳的危险因素(P＜0.05).结论 PKEP是一种有效的手术方式.糖尿病及剜除时间是经尿道等离子剜除术预后的危险因素.积极调控患者血糖,提高技术,缩短剜除手术时间,能够让患者获得更好的预后.

Abstract

Objective To analyze the risk factors of poor prognosis of the lower urinary tract symptoms after the operation of plasma kinetic enucleation of prostate(PKEP).Methods The data of a total 148 benign prostatic hyperplasia(BPH)patients who underwent PKEP at Zigong First People's Hospital from May 2020 to January 2022 were collected as the study objects,and they were divided into two groups according to the international prostate symptom score(IPSS):they were divided into the good prognosis group(59 cases)if IPSS was above 8 at the third month after PKEP and the poor prognosis group(89 cases)if the IPSS below 7.Data would be collected such as age,body mass index,complications,preoperative IPSS,prostate volume,duration of enucleation,amount of bleeding.The variables with significant differences were analyzed by binary logistic analysis.Results The IPSS at the third month after PKEP of the good prognosis group(4.93±1.16)points was lower than the IPSS at the third month after PKEP of the bad prognosis group(10.81±2.18)points,and the difference was statistically significant(P＜0.05).Free prostate specific antigen(fPSA),body mass index(BMI),prostate volume(PV),the resected mass of prostate,preoperative IPSS scores,the duration of resecting prostate,amount of bleeding,maximum flow rate(Qmax),the occurrence of diabetes were significant different between the good outcomes group and the poor outcomes group(P＜0.05).Diabetes(β=0.516,OR=1.236,95％CI=1.106-2.539)and the duration of enucleation(β=0.019,OR=1.023,95％CI=1.010-1.037)were the risk factors of poor prognosis of PKEP(P＜0.05).Conclusion PKEP can effectively improve lower urinary tract symptoms in patients with benign prostatic hyperplasia.Diabetes and duration of enucleation may be the risk factors for poor prognosis after PKEP.Actively regulating patients'blood sugar,improving techniques,and shortening the time of enucleation surgery can help patients achieve better prognosis.

关键词

良性前列腺增生/下尿路症状/国际前列腺症状评分/经尿道前列腺电切/经尿道前列腺等离子剜除/预后

Key words

Benign prostatic hyperplasia/Lower urinary tract symptoms/International prostate symptom score/Transurethral resection prostate/Plasma kinetic enucleation of the prostate/Prognosis

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基金项目

四川省自贡市科技计划(2020ZC05)

出版年

2024

中国当代医药

中国保健协会当代创新（北京）医药科学研究院

中国当代医药

影响因子：1.215

ISSN：1674-4721

参考文献量21

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