本文選題：良性前列腺增生 + 經尿道前列腺等離子電切術��； 參考：《福建醫(yī)科大學》2014年碩士論文

【摘要】：目的：探討經尿道前列腺等離子電切術（PKRP）后發(fā)生尿道狹窄的危險因素及其防治措施。 方法：福建醫(yī)科大學附屬第一醫(yī)院泌尿外科2011年1月-2013年12月因BPH行PKRP術的患者684例，其中2011年225例，2012年217例，，2013年242例。術后發(fā)生尿道狹窄的患者15例（尿道狹窄組），其年齡為59-87（71.4±7.1）歲。分別從各年份中隨機抽取未發(fā)生尿道狹窄的病例15例，共45例（無尿道狹窄組），其年齡為57-88（72.9±7.2）歲。 通過對患者再次入院就診、查閱電子病歷和電話方式進行隨訪，收集此60例患者的數據資料。為分析TURP術后患者發(fā)生尿道狹窄的危險因素，選用包括患者年齡、BPH病程時間、術前尿路感染、術前前列腺大小、手術切除前列腺重量、手術時間、術后留置導尿管時間7個指標。所有數據使用SPSS17.0軟件進行分析。計量資料使用獨立樣本t檢驗，數據用均數±標準差（x±s）表示；計數資料使用χ2檢驗；P＜0.05有統(tǒng)計學意義；篩選出P＜0.05的自變量，納入Logistic回歸模型進行多因素分析。 結果：患者年齡、BPH病程時間、術前前列腺大小、手術切除前列腺重量、手術時間五項因素其P＞0.05，與PKRP術后尿道狹窄的發(fā)生無相關性。術前尿路感染、術后留置導尿管時間兩項因素的P＜0.05，與PKRP術后尿道狹窄的發(fā)生有相關性。進一步的Logistic多因素分析結果顯示，術前尿路感染、術后留置導尿管時間是PKRP術后發(fā)生尿道狹窄的獨立危險因素（P＜0.05），OR值分別為8.050、1.607。 結論：術前合并尿路感染、術后留置導尿管時間過長是PKRP術后發(fā)生尿道狹窄的獨立危險因素。積極控制術前及術后尿路感染、避免術中操作損傷、術后留置導尿管不宜過粗、留置時間不宜過長等是預防PKRP術后發(fā)生尿道狹窄的有效措施。加強對PKRP術后患者的隨訪，做到早發(fā)現、早治療，并根據狹窄的部位、長度、程度等因素選擇合適的治療方法，是PKRP術后尿道狹窄治愈的關鍵。
[Abstract]:Objective: to investigate the risk factors and prevention of urethral stricture after transurethral plasma resection of prostate (TURP).Methods: from January 2011 to December 2013, 684 patients underwent PKRP in Urology Department of the first affiliated Hospital of Fujian Medical University, including 225 cases in 2011, 217 cases in 2012 and 242 cases in 2013.There were 15 patients with urethral stricture after operation (the age of urethral stricture group was 71.4 鹵7.1 years old).15 cases of urethral stricture were randomly selected from each year. There were 45 cases (no urethral stricture group) whose age was 57-88 (72.9 鹵7.2) years.The data of 60 patients were collected through readmission, electronic medical records and telephone follow-up.In order to analyze the risk factors of urethral stricture after TURP, the age and duration of urethral stricture, urinary tract infection before operation, prostate size before operation, the weight of prostatic gland after operation, and operative time were selected to analyze the risk factors of urethral stricture.Postoperative indwelling urethral catheter time 7 indicators.All data are analyzed using SPSS17.0 software.The measured data were expressed by the mean 鹵standard deviation (x 鹵s) and the count data by 蠂 2 test (P < 0. 05). The independent variables of P < 0. 05 were screened out and analyzed by Logistic regression model.Results: the age and duration of PKRP, the size of prostate before operation, the weight of resection prostate and the operative time had no correlation with the occurrence of urethral stricture after PKRP.Urinary tract infection before operation and time of indwelling urethral catheter after operation (P < 0.05) were correlated with the occurrence of urethral stricture after PKRP.Further Logistic multivariate analysis showed that preoperative urinary tract infection and postoperative indwelling time were independent risk factors for urethral stricture after PKRP (P < 0.05) and OR values were 8.050 鹵1.607, respectively.Conclusion: preoperative urinary tract infection and postoperative catheter length are independent risk factors for urethral stricture after PKRP.The effective measures to prevent urethral stricture after PKRP are to control urinary tract infection before and after operation, to avoid operative injury, to prevent urethral stricture after PKRP.The key to cure urethral stricture after PKRP is to strengthen the follow-up of patients after PKRP, to find and treat it early, and to select appropriate treatment methods according to the location, length and degree of stenosis.
【學位授予單位】：福建醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R699.6


本文編號：1769091