CAJ | 학술논문

目的：应用衰弱评分系统预测老年患者行经尿道前列腺电切术（ TURP）的围手术期手术并发症发生率，探讨其预测价值。方法前瞻性观察2012年6月至2014年10月间，年龄大于60岁行TURP的患者。术前依据Fried衰弱评分，分为3组，0～1分为无衰弱组，2～3分为轻度衰弱组，4～5分为衰弱组，比较各组术后并发症发生率及住院时间。结果共纳入107例患者，年龄61～92岁，平均年龄（72.22±7.96）岁，术前无衰弱组占28.0%（30/107）；轻度衰弱组29.0%（31/107）；衰弱组43.0%（46/107）。衰弱组术后并发症发生率（32%）明显高于轻度衰弱组（12%）和无衰弱组（6%），差异有显著性（ P <0.01）；衰弱组术后住院时间（14.72±5.60天）明显长于轻度衰弱组（12.87±3.19天）和无衰弱组（10.40±1.61天），差异均有显著性（ P <0.01）。衰弱指数预测术后并发症发生率的ROC曲线面积为0.792（95% CI：0.704～0.880；P <0.001）。结论术前衰弱评分可预测老年前列腺增生症患者行TURP术后的并发症发生率。
목적：응용쇠약평분계통예측노년환자행경뇨도전렬선전절술（ TURP）적위수술기수술병발증발생솔，탐토기예측개치。방법전첨성관찰2012년6월지2014년10월간，년령대우60세행TURP적환자。술전의거Fried쇠약평분，분위3조，0～1분위무쇠약조，2～3분위경도쇠약조，4～5분위쇠약조，비교각조술후병발증발생솔급주원시간。결과공납입107례환자，년령61～92세，평균년령（72.22±7.96）세，술전무쇠약조점28.0%（30/107）；경도쇠약조29.0%（31/107）；쇠약조43.0%（46/107）。쇠약조술후병발증발생솔（32%）명현고우경도쇠약조（12%）화무쇠약조（6%），차이유현저성（ P <0.01）；쇠약조술후주원시간（14.72±5.60천）명현장우경도쇠약조（12.87±3.19천）화무쇠약조（10.40±1.61천），차이균유현저성（ P <0.01）。쇠약지수예측술후병발증발생솔적ROC곡선면적위0.792（95% CI：0.704～0.880；P <0.001）。결론술전쇠약평분가예측노년전렬선증생증환자행TURP술후적병발증발생솔。
Objective To determine the relationship between preoperative frailty and the occurrence of postoperative complications after transurethral resection of prostate( TURP)operations in the older patients with benign prostatic hyperplasia( BPH). Methods Patients 60 years or older undergoing elective TURP surgery were enrolled. Five baseline frailty traits were measured preoperatively. Patients were categorized by the number of positive traits as follows:nonfrail:0 to 1 trait,intermediately frail:2 to 3 traits,and frail:4 or more traits. Results One hundred and seven subjects(age from 61 to 92,72.22 ±7.96 years)were studied. Preoperative frailty was associated with increased postoperative complica-tions(frail 32% vs. intermediately 12% vs. nonfrail 6%;P <0.01)and longer hospital stays(frail 14.72 ±5.60 vs. intermediately frail 12. 87 ± 3. 19 vs. nonfrail 10. 40 ± 1. 61 day,P <0. 01)after TURP. The area under receiver operating characteristic curves examining frailtyˊs ability to forecast TURP complications was 0. 792(95% CI:0. 704~0. 880,P <0. 001). Conclusion The preoperative frailty score may predict post-operative complications in the older BPH patients undergoing TURP Surgery.