多因素回归分析良性前列腺增生电切术后并发膀胱过度活动综合征的影响因素

目的 经尿道前列腺电切术(TURP)是处理良性前列腺增生(BPH)引起下尿路梗阻症状的最好方式，然而，术后仍一定数量患者的膀胱过度活动综合征(OAB)症状未见缓解，探讨良性前列腺增生电切术后并发膀胱过度活动综合征的影响因素具有非常重要的意义。 方法 收集丽水市中心医院2011年6月—2014年6月收治的BPH患者286例的临床资料，患者均行TURP治疗，单因素对比分析2组患者的前列腺体积、残余尿量、平均尿流率、最大尿流率、逼尿肌稳定性、国际前列腺症状评分(IPSS)、生活质量评估(QOL)评分、泌尿系感染、尿潴留等，并进一步行多因素非条件Logistic回归分析前列腺增生电切术后并发膀胱过度活动综合征的影响因素。 结果 所有患者均顺利行TURP术，术后OAB症状未缓解的共有42例(观察组)，OAB症状缓解的共有244例(对照组)，通过对比分析2组患者观察指标结果提示，与对照组患者相比，观察组患者前列腺体积更大，残余尿量更多，最大尿流率更小，逼尿肌稳定性更差及IPSS评分更高，差异有统计学意义(P＜0.05)。应用多因素非条件Logistic回归分析结果显示，术前患者更小的最大尿流率、更差的逼尿肌稳定性及更高的IPSS评分显著增加TURP术后OAB症状的风险(P＜0.05)。 结论 TURP术后并发OAB症状与患者最大尿流率、逼尿肌稳定性及IPSS评分相关，应积极控制风险因素，以提高患者生活质量并改善预后。 

Factors affecting the postoperative bladder over activity syndrome in patients with benign prostatic hyperplasia after TURP

Objective Transurethral resection of the prostate(TURP)is the best way to deal with the symptoms of lower urinary tract obstruction caused by benign prostatic hyperplasia(BPH).However,there is no significant effect on the overactive bladder(OAB)symptoms among certain number of patients after the surgery. Methods The clinical data of 286 cases of patients with BPH were collected in our hospital from June 2011 to June 2014.All the patients underwent TURP.Single-factor ANOVA was performed among the prostate volume,residual urine volume,average flow rate of urinary,maximum flow rate of urinary,detrusor and stability,IPSS score,QOL score,urinary tract infection and urinary retention.Multiple-factor non-conditional logistic regression analysiswas performed evaluate the influence factors of postoperative overactive bladder syndrome after TURP. Results TURPwere successfully performed in all patients.After the operations,OAB symptoms were not alleviated in 42 cases(observation group),alleviated in 244 cases(control group).As compared with the control group,The patients in the observation group were with greater prostate volume,more residual urine,less maximum flow rate of urinary,poor detrusor stability,and higher IPSS score,the difference was statistically significant(P<0.05).Multiple-factor non-conditional logistic regression analysis showed that preoperative less maximum urinary flow rate,poor detrusor stability and higher IPSS score could increase the risk of OAB symptoms after TURP(P<0.05). Conclusion OAB symptoms after TURP were correlated with maximum urinary flow rate(Qmax),detrusor instability and IPSS score.These risk factors should be actively controlled to improve the quality of life and prognosis of patients.