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良性前列腺增生症患者经尿道前列腺电切术术后复发再手术危险因素分析

Risk factors of recurrence after transurethral resection of the prostate due to benign prostate hyperplasia

摘要:

目的 回顾四川大学华西医院2002年11月 至2007年11月因良性前列腺增生症(BPH)入院行经尿道前列腺电切术(TuRP)治疗的患者的临床资料,综合分析BPH患者TURP术后复发再手术的危险因素.方法 回顾1471例行TURP治疗的BPH患者的临床资料,其中41例术后复发再次入院手术治疗.资料包括:患者的下尿路症状、发病年龄、手术时年龄、前列腺大小、尿流动力学资料、血清前列腺特异抗原、血常规、尿常规、血清肌酐、手术切除前列腺组织重量、手术持续时间、住院时间、手术者年资及病理标本炎症分级评分等.结果 单因素统计分析:患者发病年龄(t=2.292,P=0.086),术前前列腺大小(t=-1.987,P=0.047),尿不尽症状发生率(x~2=9.240,P=0.002),术前膀胱残余尿量(t=2.181,P=0.030)及手术者年资高低情况(Z=10.13,P=0.0015)两组资料间差异有统计学意义.多因素Logistic回归分析:按α=0.20水准纳入单因素分析中有意义因素作为自变量,以是否复发作为因变量,引入非条件Logistic回归方程.分别采用向前及向后逐步回归法,筛选出的危险因素为:病理标本炎症分级评分、手术者年资、尿不尽、血清肌酐含量、发病年龄,其中病理标本炎症分级评分(OR=0.905)、尿不尽(OR=0.557)、手术者年资(OR=0.393)有显著影响.结论 BPH患者TURP术后复发可能危险因素为:手术者年资低,发病年龄小,无尿不尽症状,前列腺大,残余尿量少,病理标本炎症分级评分低.

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abstracts:

Objectives To review the clinic data of benign prostate hyperplasia ( BPH) cases, andto find the risk factors of recurrence in post transurethral resection of the prostate ( TURP) patients. Methods From November 2002 to November 2007, 1471 cases were reviewed, including 41 patients of recurrence after TURP. Record the data include onset age, course of disease, age of surgery, LUTS, PSA, blood serum creatinine, size of the prostate in transabdomen ultrasonography, data of urodynamic examination, weight of resected tissue, persistence time of the resection, length of stay, score of inflammation of the pathologic sample, experience of the operator, routine blood examination, routine urine examination and so on. Statistical analysis was performed using univariate and multivariate unconditional Logistic regression analysis for evaluation of the data. Results In the univariate analysis, onset age (t = 2. 292, P = 0. 086) , PVR(t =2. 181 ,P =0. 03) , size of the prostate in transabdomen ultrasonography (t = - 1. 987, P = 0. 047), experience of the operator( Z = 10. 13, P = 0. 0015) and the symptom that bladder does not feel completely empty right after urinating ( x~2 =9. 240, P = 0.002 ) had statistical significance. In the multivariate unconditional Logistic regression analysis, Odds ratio (OR) of the factors were investigated, the symptom that bladder does not feel completely empty right after urinating (OR =0.557), the score for inflammation (OR =0.905) and experience of the operator (OR =0. 393 ) had statistical significance. Conclusions The risk factors for elevating the incidence of post-TURP recurrence are the lower score for inflammation, younger onset age, having the symptom that bladder does not feel completely empty right after urinating, bigger size of prostate in transabdomen ultrasonography, lower postvoid residual urine volume and poor experience of the operator.

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作者: 赖建宇 [1] 宋灵敏 [1] 朱育春 [1] 魏强 [1]
第一作者: 赖建宇
期刊: 《中华外科杂志》2010年48卷2期 103-107页 MEDLINEISTICPKUCSCD
分类号: R6
栏目名称: 论著
DOI: 10.3760/cma.j.issn.0529-5815.2010.02.007
发布时间: 2010-04-06
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