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目的:探讨经尿道前列腺电切(TURP)术后发生继发性出血的相关危险因素。方法:回顾性分析2011年9月~2014年8月339例前列腺增生症(BPH)患者行TURP的临床资料,对可能影响术后发生继发性出血的相关因素进行单因素及多因素Logistic回归分析。结果:339例BPH患者TURP术后发生继发性出血31例,发生率9.14%;单因素分析显示前列腺体积大、合并精尿病、合并高血压、术前1周内并发尿路感染、术前1周内留置尿管、未使用硬膜外镇痛泵者术后出血率较高,分别为14.04%,29.17%,12.99%,17.76%,13.91%,22.03%,差异有统计学意义(P<0.05或0.01);多因素Logistic回归分析显示,前列腺体积(OR=4.14),术前1周内并发尿路感染(OR=2.80)、合并糖尿病(OR=4.81)是术后继发性出血的独立危险因素,使用硬膜外镇痛泵(OR=0.46)是保护因素。结论:前列腺体积大、术前1周内并发尿路感染、合并糖尿病使TURP术后继发性出血的风险增加,使用硬膜外镇痛泵能降低TURP术后继发性出血的风险。
Objective: To explore the related risk factors of secondary hemorrhage after transurethral resection of prostate (TURP). Methods: The clinical data of TURP in 339 cases of benign prostatic hyperplasia (BPH) from September 2011 to August 2014 were retrospectively analyzed. One-factor and multivariate logistic regression analysis were performed on the related factors that may influence the secondary postoperative bleeding. analysis. Results: Thirty-one patients with BPH developed secondary bleeding after TURP, with a rate of 9.14%. Univariate analysis showed that the prostate was bulky, had combined with diabetes mellitus and hypertension, and had urinary tract infection within one week before operation The rate of postoperative bleeding was 14.04%, 29.17%, 12.99%, 17.76%, 13.91% and 22.03% respectively in the first week after catheterization without epidural analgesia. The difference was statistically significant ( P <0.05 or 0.01). Multivariate logistic regression analysis showed that prostate volume (OR = 4.14), urinary tract infection within 1 week before surgery (OR = 2.80) and diabetes mellitus (OR = 4.81) An independent risk factor for bleeding, using an epidural analgesia pump (OR = 0.46) was a protective factor. CONCLUSIONS: The prostate is bulky and has urinary tract infection within 1 week before surgery. The risk of secondary bleeding after TURP is increased with diabetes. Epidural analgesia pump can reduce the risk of secondary bleeding after TURP.