摘要
目的分析前列腺增生术后膀胱痉挛的危险因素,并建立列线图预测模型。方法选取收治的前列腺增生并行汽化电切术的患者246例,根据患者术后是否出现膀胱痉挛分为痉挛组与未痉挛组。采用单因素分析与多因素logistic回归分析筛选影响前列腺增生术后膀胱痉挛的危险因素,基于危险因素,采用R软件建立列线图预测模型,并对模型进行内部验证,评估预测的区分度与准确度。结果多因素logistic回归分析结果显示,术前焦虑、冲洗液温度<34℃、冲洗液速度<60或>80滴/min、尿管气囊注水量40 mL、引流管堵塞是前列腺增生术后膀胱痉挛的独立危险因素(P<0.05);基于影响术后膀胱痉挛的危险因素建立列线图预测模型,并经Bootstrap法重复抽样100次进行内部验证,校准曲线预测值与实际值基本一致,Hosmer-Lemeshow拟合优度检验χ^(2)=2.462,P=0.963,ROC曲线下面积为0.848(95%CI:0.791~0.904)。结论基于影响前列腺增生术后膀胱痉挛的危险因素建立的列线图预测模型具有良好的预测准确度与区分度,可为预防前列腺增生手术患者术后膀胱痉挛提供一定指导价值。
Objective To analyze the risk factors of bladder spasm after prostatic hyperplasia and to establish a nomogram prediction model.Methods From May 2018 to August 2020,246 patients with prostate hyperplasia,who received electrovaporization,were selected in our hospital.According to whether the patients had bladder spasm after surgery,they were divided into spasm group and non-spasm group.Single-factor analysis and multi-factor logistic regression analysis were used to screen the risk factors affecting bladder spasm after prostatic hyperplasia surgery.Based on the risk factors,R software was used to establish a nomogram prediction model,and the model was internally verified to assess the discrimination and accuracy of the prediction degree.Results The results of multivariate logistic regression analysis showed that preoperative anxiety,flushing fluid temperature<34℃,flushing fluid speed<60 or>80 drops/min,urinary balloon injection volume of 40 mL,and drainage tube blockage were independent risk factors for bladder spasm after prostatic hyperplasia surgery(P<0.05).A nomogram prediction model was established based on the risk factors affecting postoperative bladder spasm,and the Bootstrap method was used to repeat sampling 100 times for internal verification.The predicted value of the calibrated curve was basically consistent with the actual value.Hosmer-Lemeshow goodness of fit showed that χ^(2)=2.462 and P=0.963,and the area under the ROC curve was 0.848(95%CI:0.791-0.904).Conclusion The nomogram prediction model based on the risk factors affecting the bladder spasm after prostatic hyperplasia surgery has good prediction accuracy and discrimination,and can provide certain guidance value for preventing bladder spasm after prostatic hyperplasia surgery.
作者
郑金华
陈烈钳
陈景宇
谢进东
ZHENG Jin-hua;CHEN Lie-qian;CHEN Jing-yu;XIE Jin-dong(Department of Urology,Huizhou FirstPeople′s Hospital,Huizhou 516000,Guangdong,China)
出处
《广东医学》
CAS
2022年第1期70-74,共5页
Guangdong Medical Journal
基金
广东省医学科研基金项目(A2018235)。
关键词
前列腺增生
膀胱痉挛
危险因素
个体化预测
prostatic hyperplasia
bladder spasm
risk factors
individualized prediction
