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

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。%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.