衰弱评分与老年患者行经尿道前列腺电切术围手术期并发症发生率关系的研究

摘要

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.%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。