中华外科杂志
中華外科雜誌
중화외과잡지
CHINESE JOURNAL OF SURGERY
2010年
2期
103-107
,共5页
赖建宇%宋灵敏%朱育春%魏强
賴建宇%宋靈敏%硃育春%魏彊
뢰건우%송령민%주육춘%위강
前列腺增生症%经尿道前列腺切除术%复发%危险因素
前列腺增生癥%經尿道前列腺切除術%複髮%危險因素
전렬선증생증%경뇨도전렬선절제술%복발%위험인소
]Prostate hyperplasia%Transurethral resection of the prostate%Recurrence%Riskfactors
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.
目的 迴顧四川大學華西醫院2002年11月 至2007年11月因良性前列腺增生癥(BPH)入院行經尿道前列腺電切術(TuRP)治療的患者的臨床資料,綜閤分析BPH患者TURP術後複髮再手術的危險因素.方法 迴顧1471例行TURP治療的BPH患者的臨床資料,其中41例術後複髮再次入院手術治療.資料包括:患者的下尿路癥狀、髮病年齡、手術時年齡、前列腺大小、尿流動力學資料、血清前列腺特異抗原、血常規、尿常規、血清肌酐、手術切除前列腺組織重量、手術持續時間、住院時間、手術者年資及病理標本炎癥分級評分等.結果 單因素統計分析:患者髮病年齡(t=2.292,P=0.086),術前前列腺大小(t=-1.987,P=0.047),尿不儘癥狀髮生率(x~2=9.240,P=0.002),術前膀胱殘餘尿量(t=2.181,P=0.030)及手術者年資高低情況(Z=10.13,P=0.0015)兩組資料間差異有統計學意義.多因素Logistic迴歸分析:按α=0.20水準納入單因素分析中有意義因素作為自變量,以是否複髮作為因變量,引入非條件Logistic迴歸方程.分彆採用嚮前及嚮後逐步迴歸法,篩選齣的危險因素為:病理標本炎癥分級評分、手術者年資、尿不儘、血清肌酐含量、髮病年齡,其中病理標本炎癥分級評分(OR=0.905)、尿不儘(OR=0.557)、手術者年資(OR=0.393)有顯著影響.結論 BPH患者TURP術後複髮可能危險因素為:手術者年資低,髮病年齡小,無尿不儘癥狀,前列腺大,殘餘尿量少,病理標本炎癥分級評分低.
목적 회고사천대학화서의원2002년11월 지2007년11월인량성전렬선증생증(BPH)입원행경뇨도전렬선전절술(TuRP)치료적환자적림상자료,종합분석BPH환자TURP술후복발재수술적위험인소.방법 회고1471례행TURP치료적BPH환자적림상자료,기중41례술후복발재차입원수술치료.자료포괄:환자적하뇨로증상、발병년령、수술시년령、전렬선대소、뇨류동역학자료、혈청전렬선특이항원、혈상규、뇨상규、혈청기항、수술절제전렬선조직중량、수술지속시간、주원시간、수술자년자급병리표본염증분급평분등.결과 단인소통계분석:환자발병년령(t=2.292,P=0.086),술전전렬선대소(t=-1.987,P=0.047),뇨불진증상발생솔(x~2=9.240,P=0.002),술전방광잔여뇨량(t=2.181,P=0.030)급수술자년자고저정황(Z=10.13,P=0.0015)량조자료간차이유통계학의의.다인소Logistic회귀분석:안α=0.20수준납입단인소분석중유의의인소작위자변량,이시부복발작위인변량,인입비조건Logistic회귀방정.분별채용향전급향후축보회귀법,사선출적위험인소위:병리표본염증분급평분、수술자년자、뇨불진、혈청기항함량、발병년령,기중병리표본염증분급평분(OR=0.905)、뇨불진(OR=0.557)、수술자년자(OR=0.393)유현저영향.결론 BPH환자TURP술후복발가능위험인소위:수술자년자저,발병년령소,무뇨불진증상,전렬선대,잔여뇨량소,병리표본염증분급평분저.
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.
