文章摘要

单纯前列腺增生术后尿源性感染的影响因素及相关指标的预测价值

作者: 1郭帅, 1蒋民军, 1陈建春, 1马峥
1 苏州市第九人民医院泌尿外科，江苏 苏州 215000
通讯: 马峥 Email: mazheng851230@yeah.net
DOI: 10.3978/j.issn.2095-6959.2022.10.022
基金: 苏州市“科教兴卫”青年科技项目(KJXW2020074)。

摘要

目的：探讨单纯前列腺增生(benign prostatic hyperplasia，BPH)术后尿源性感染的相关因素分析及相关指标的预测价值。方法：回顾性分析2019年1月至2021年10月行经尿道前列腺等离子切除术(transurethral resection of the prostate，TURP)治疗的148例单纯BPH患者临床资料，根据术后是否发生尿源性感染分为感染组(n=26)与未感染组(n=122)。采用单因素分析、多因素logistic回归分析单纯BPH术后尿源性感染的相关因素，并分析单纯BPH术后1 d的血白细胞(white blood cell，WBC)和C反应蛋白(C-reactive protein，CRP)对单纯BPH术后尿源性感染的预测价值。结果：单因素分析显示年龄、糖尿病史、前列腺重量、术前留置导尿管、手术时间可能与单纯BPH术后尿源性感染有关(P<0.05)，而体重指数(body mass index，BMI)、病程、吸烟史、饮酒史、高血压史、高脂血症史、术前预防性应用抗生素、术中出血量、术后留置导尿管时间、住院时间、术后膀胱冲洗时间等与单纯BPH术后尿源性感染无关(P>0.05)。多因素logistic回归分析显示：年龄[比值比(odds ratio，OR)=1.108，95%CI：1.020~1.204]、糖尿病史(OR=5.674，95%CI：1.978~16.264)、术前留置导尿管(OR=3.169，95%CI：1.072~9.371)为单纯BPH术后尿源性感染的独立危险因素(P<0.05)。受试者工作特征(receiver operating characteristic，ROC)曲线显示：术后1 d血WBC、CRP对单纯BPH术后尿源性感染具有一定预测价值[曲线下面积(area under the curve，AUC)分别为0.653、0.713]，其中联合预测价值较高(AUC=0.782)。结论：年龄、糖尿病史、术前留置导尿管为单纯BPH术后尿源性感染的独立危险因素，联合WBC和CRP指标对于单纯BPH术后尿源性感染有较高预测价值。
关键词： 前列腺增生；尿源性感染；影响因素；预测价值

Influencing factors of urinary infection after simple benign prostatic hyperplasia operation and the predictive value of related indexes

Authors: 1GUO Shuai, 1JIANG Minjun, 1CHEN Jianchun, 1MA Zheng
1 Department of Urology, Suzhou Ninth People’s Hospital, Suzhou Jiangsu 215000, China

CorrespondingAuthor: MA Zheng Email: mazheng851230@yeah.net

DOI: 10.3978/j.issn.2095-6959.2022.10.022

Foundation: This work was supported by the Suzhou “Science and Education Revitalize Health” Youth Science and Technology Project, China (KJXW2020074).

Abstract

Objective: To explore the analysis of related factors and the predictive value of related indicators of urinary infection after simple benign prostatic hyperplasia (BPH) operation. Methods: A retrospective analysis was made on the clinical data of 148 patients with simple BPH who underwent transurethral resection of the prostate (TURP) from January 2019 to October 2021. According to whether urinary infection occurred after the operation, they were divided into a infection group (26 cases) and an uninfected group (122 cases). Univariate analysis and multivariate Logistic regression were used to analyze the related factors of urinary infection after simple BPH operation, and the predictive value of white blood cell (WBC) and C-reactive protein (CRP) 1 d after simple BPH operation was analyzed. Results: Univariate analysis shows that age, history of diabetes, prostate weight, preoperative indwelling catheter, and operation time may be related to urinary infection after simple BPH operation (P<0.05), while body mass index (BMI), the course of the disease, smoking history, drinking history, hypertension history, hyperlipidemia history, antibiotic prophylaxis, intraoperative blood loss, length of hospitalization, and the time of posterior bladder irrigation had nothing to do with urinary infection after simple BPH operation (P>0.05). Multivariate logistic regression analysis showed that age [odds ratio (OR)=1.108, 95%CI 1.020 to 1.204], diabetes history (OR=5.647, 95%CI 1.978 to 16.264), preoperative indwelling catheter (OR=3.169, 95%CI 1.072 to 9.371) were independent risk factors for urinary infection after simple BPH operation (P<0.05). The receiver operating characteristic (ROC) curve showed that WBC and CRP had a certain predictive value for urinary infection after simple BPH operation [area under the curve (AUC)=0.653, 0.713, respetively], and the combination (AUC=0.782) had a higher predictive value. Conclusion: Age, history of diabetes, and preoperative indwelling catheter are independent factors for postoperative urinary infection after simple BPH operation. Combined WBC and CRP has a higher predictive value for postoperative urinary infection after simple BPH operation.

Keywords： benign prostatic hyperplasia; urinary infection; influencing factors; predictive value

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