急性尿潴留增加患者经尿道前列腺电切术后早期并发症的风险

doi:j.issn.1009-976X.2014.02.021

摘要/Abstract

摘要： 【摘要】〓目的〓探讨前列腺增生患者(BPH)术前伴有急性尿潴留(AUR)经尿道前列腺电切术(TURP)后早期并发症。方法〓回顾性分析我院2010年1月~2011年12月因BPH行TURP术的患者临床资料,年龄大于50岁的BPH患者仅行TURP术为我们的研究对象,将其分为两组,一组术前AUR(+),另一组术前AUR(-),神经源性膀胱、前列腺癌、药物或尿道狭窄所致AUR患者不纳入本研究。对比两组患者术后早期并发症:尿路感染(UTI)、血尿、重置尿管、尿失禁、休克、输血率、败血症、下尿路症状(LUTS)。结果〓AUR(+)组144例,AUR(-)组116例,AUR(+)组与AUR(-)相比,术后尿路感染(45.83% vs 10.34%, OR:7.33, 95% CI:3.71~14.50)、血尿(19.4% vs 6.9%, OR: 3.25, 95% CI: 1.41~7.50)、重置尿管(8.33% vs 2.59%, OR: 3.42, 95% CI: 0.94~12.44),差异具有统计学意义;尿失禁(1.39%)、休克(0.69%)、输血(4.17%)仅发生在AUR(+)组,LUTS症状、败血症在两组差异无统计学意义。结论〓术前伴有AUR患者TURP术后早期并发症的风险较不伴有AUR的患者更高。

关键词: 良性前列腺增生, 经尿道前列腺电切术, 急性尿潴留, 术后早期并发症

Abstract: 【Abstract】〓Objective〓To investigate the early postoperative complications after transurethral resection of prostate (TURP) in patients with acute urinary retention (AUR). Methods〓The clinical data of patients with benign prostatic hyperplasia (BPH) and with or without AUR were analyzed retrospectively from January 2010 to December 2011. All patients with or without AUR underwent TURP [AUR (+) groups, n=144, AUR (-) groups, n=116]). The early postoperative complications were compared between two groups,including urinary tract infection (UTI),hematuria,re-catheterization, urinary incontinence, shock, blood transfusions, septicemia and lower urinary tract symptoms (LUTS). Results〓The AUR(+) group had more UTIs (45.83% vs 10.34%, OR:7.33, 95% CI: 3.71-14.50), more hematuria (19.4% vs 6.9%,OR:3.25,95% CI:1.41-7.50) and more re-catheterization (8.33% vs 2.59%, OR: 3.42, 95% CI: 0.94-12.44). Urinary incontinence (1.39%), shock (0.69%) and blood transfusions (4.17%) were found only in the AUR (+) group. There were no statistical significance of LUTS and septicemia in both groups. Conclusion〓The patients with AUR have a higher risk of early postoperative complications.

Key words: Benign prostate hyperplasia (BPH), Transurethral resection of prostate (TURP), Acute urinary retention (AUR), Early postoperative complications

中图分类号:

R697+.3

罗欣杨翔林宇峰李杰贤陈凤婷谢文练. 急性尿潴留增加患者经尿道前列腺电切术后早期并发症的风险[J]. 岭南现代临床外科, 2014, 14(02): 186-189.

Luo Xin, Yang Xiang, Lin Yufeng, Li Jiexian,Chen Fengtin, Xie Wenlian. Acute urinary retention increases the risk of early complications of patients after transurethral resection of the prostate[J]. Lingnan Modern Clinics in Surgery, 2014, 14(02): 186-189.

参考文献

[1] Diavan B,Madersbacher S，Kingler C，et al . Urodynamic assessment of patients with acute urinary retention：Is treatment failure after prostatectory predictable？J Urol,l997,l58:l829.
[2] Emberton M，Anson K．Acute urinary retention in men：an age old
problem[J]．BMJ,1999,318(7188)：921-925.
[3] Mamoulakis C, Efthimiou I, Kazoulis S, Christoulakis I, Sofras F. The modified Clavien classification system: a standardized platform for reporting complications in transurethral resection of the prostate. World J Urol.2011.29(2):205-210.
[4] Choong S , Emberton M . Acute urinary retention . BJU Int 2000;85: 186-201
[5] 张祥华．良性前列腺增生诊断治疗指南[M] 那彦群．中国泌尿外科疾病诊断治疗指南．第2版．北京：人民卫生出版社，2007：167—204．
[6] Pickard R , Emberton M , Neal DE . The management of men with acute urinary retention.National Prostatectomy Audit Steering Group . Br J Urol 1998;81:712-720
[7] Loh SY, Chin CM. A demographic profile of patients undergoing transurethral resection of the prostate for benign prostate hyperplasia and presenting in acute urinary retention .BJU Int 2002;89:531-533
[8] Dubey D，Kumar A，Kapoor R，et a1．Acute urinary retention：defining the need and timing for pressure—flow studies[J]．BJU Int，2001，88(3)：178—182．
[9] Djavan B，Madersbacher S，KingIer C，et aI. Urodynamic assessment
of patients with acute urinary retention：Is treatment faiIure after prostatectomy predictable？J Urol，1997，158（8）：1829
[10] RadomskiSB,Herschorn S,Naglie G.acute urinary retention in men:a comparison of voiding and nonvoiding patients after prostatectomy.J Urol.1995:153(3 pt l):655一658.
[11] Dubey D,Kumar A,Kapoor R,et al.Acute urinary retention:defining the need and timing for pressure一flow studies.BJU Int.2001;88(3):178一182
[12] Pickard R , Emberton M , Neal DE . The management of men with acute urinary retention. National Prostatectomy Audit Steering Group . Br J Urol 1998;81:712-20
[13] Jeng-Sheng Chen,Chia-Hsien Chang,Wen-Horng Yang,et al.Acute urinary retention increases the risk of complications after transurethral resection of the prostate: a population-based study. 〔J〕.2012 BJU int 110, E896-E901
[14] ZONG HT,PENG XX,YANG CC,et al.A systematic review of the effects and mechanisms of preoperative 5ɑ-reductase inhibitors on intraoperative haemorrhage during surgery for benign prostatic hyperplasia[J].Asian J Androl,2011,10:1038.
[15] Kuntz RM , Ahyai S , Lehrich K , Fayad A . Transurethral holmium laser enucleation of the prostate versus transurethral electrocautery resection of the prostate: a randomized prospective trial in 200 patients . J Urol 2004;172:1012–6。