影响达芬奇辅助腹腔镜前列腺根治性切除术后尿控恢复的因素分析
Factors Influencing the Recovery of Urinary Control after Da Vinci Assisted Laparoscopic Radical Prostatectomy
摘要: 目的：探讨影响达芬奇辅助腹腔镜前列腺根治性切除术后尿控恢复的因素。方法：回顾性分析2014年5月~2020年1月在我院行达芬奇系统辅助腹腔镜前列腺素癌根治术110例患者的临床资料，分析影响患者术后尿控功能恢复的相关因素。结果：本组110例患者中，术后1个月尿失禁36例，有效尿控率为67.27%，术后6个月尿失禁例7例，有效尿控率为93.64%。术后1个月，BMI ≥ 28 kg/m2 (OR = 5.122, 95% CI: 1.642~15.978, P = 0.005)增加术后尿失禁率，术后规律提肛锻炼(OR = 0.175, 95% CI: 0.054~0.569, P = 0.004)和保留NVB (OR = 0.078, 95% CI: 0.025~0.243, P = 0.000)可以提高患者的有效尿控率；术后6个月，BMI ≥ 28 kg/m2 (OR = 7.232, 95% CI: 1.018~51.376, P = 0.048)增加术后尿失禁率，术后规律提肛锻炼(OR = 0.129, 95% CI: 0.018~0.915, P = 0.040)和保留NVB (OR = 0.076, 95%CI: 0.008~0.743, P = 0.027)可以提高患者的有效尿控率；结论：达芬奇辅助腹腔镜下前列腺切除根治性术中规律的提肛锻炼和术中保留NVB可以提高患者术后的有效尿控率，而肥胖是影响达芬奇辅助腹腔镜下前列腺切除根治性术后尿控的不利因素。
Abstract: Objective: To investigate the factors influencing the recovery of urinary control after Da Vinci assisted laparoscopic radical prostatectomy. Methods: The clinical data of 110 patients who underwent laparoscopic prostaglandin radical prostatectomy assisted by Da Vinci system in our hospital from May 2014 to January 2020 were retrospectively analyzed. Results: Among 110 patients, 36 cases had urinary incontinence one month after operation, and the effective urinary control rate was 67.27%; 7 cases had urinary incontinence six months after operation, and the effective urinary control rate was 93.64%. One month after operation, BMI ≥ 28 kg /m2 (OR = 5.122, 95% CI: 1.642~15.978, P = 0.005) the rate of postoperative urinary incontinence increased; regular anal lifting exercise (OR = 0.175, 95% CI: 0.054~0.569, P = 0.004) and NVB retention (OR = 0.078, 95% CI: 0.025~0.243, P = 0.000) could improve the effective urinary control rate; six months after operation, BMI ≥ 28 kg /m2 (OR = 7.232, 95% CI: 1.018~51.376, P = 0.048) the rate of postoperative urinary incontinence increased; regular postoperative anal lifting exercise (OR = 0.129, 95% CI: 0.018~0.915, P = 0.040) and NVB retention (OR = 0.076, 95% CI: 0.008~0.743, P = 0.027) can improve the effective urinary control rate of patients. Conclusion: Regular anal lifting exercise and NVB retention during Da Vinci assisted laparoscopic radical prostatectomy can improve the effective urinary control rate of patients. It can improve the effective urinary control rate of patients after operation, and obesity is the adverse factor of urinary control after Da Vinci assisted laparoscopic radical prostatectomy.
文章引用：高瞻, 韩雪阳, 孙东凯, 姜涵中, 孙立江. 影响达芬奇辅助腹腔镜前列腺根治性切除术后尿控恢复的因素分析[J]. 临床医学进展, 2021, 11(1): 229-234. https://doi.org/10.12677/ACM.2021.111033

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