METHODS: A nested case-control study was conducted. The clinical data of patients were collected, and the incidence of POUR was analyzed. Univariate analysis was used to identify the risk factors associated with POUR, and multivariate logistic regression analysis was used to determine independent risk factors for POUR. A nomogram for the preoperative prediction of POUR using a logistic regression model was developed (n = 609).
RESULTS: The incidence of POUR after anorectal surgery for benign anorectal diseases was 19.05%. The independent risk factors for POUR were: female (P = 0.007); male with benign prostatic hyperplasia (BPH) (P = 0.001); postoperative visual analogue scale (VAS) score > 6 (P = 0.002); patient-controlled epidural analgesia (PCEA) (P = 0.016); and a surgery time > 30 min (P = 0.039). In the nomogram, BPH is the most important factor affecting the occurrence of POUR, followed by a postoperative VAS score > 6, PCEA, surgery time > 30 min, and sex has the least influence.
CONCLUSIONS: For patients undergoing anorectal surgery for benign anorectal diseases, preventive measures can be taken to reduce the risk of POUR, taking into account the following risk factors: female or male with BPH, severe postoperative pain, PCEA, and surgery time > 30 min. Furthermore, we developed and validated an easy-to-use nomogram for preoperative prediction of POUR in anorectal surgery for benign anorectal diseases.
BACKGROUND: China Clinical Trial Registry: ChiCTR2000039684, 05/11/2020.
方法:采用巢式病例对照研究。收集患者的临床资料,并对POUR的发生率进行了分析。单因素分析用于确定与POUR相关的危险因素,多因素logistic回归分析用于确定POUR的独立危险因素。使用逻辑回归模型开发了用于术前预测POUR的列线图(n=609)。
结果:良性肛肠疾病肛肠手术后POUR的发生率为19.05%。POUR的独立危险因素为:女性(P=0.007);男性合并良性前列腺增生(BPH)(P=0.001);术后视觉模拟评分(VAS)评分>6(P=0.002);患者自控硬膜外镇痛(PCEA)(P=0.016);手术时间>30min(P=0.039)。在列线图中,BPH是影响POUR发生的最重要因素,术后VAS评分>6,PCEA,手术时间>30分钟,性影响最小.
结论:对于因良性肛肠疾病而接受肛肠手术的患者,可以采取预防措施来降低POUR的风险,考虑到以下危险因素:女性或男性患有BPH,严重的术后疼痛,PCEA,手术时间>30分钟。此外,我们开发并验证了一个易于使用的列线图,用于良性肛肠疾病肛肠手术中POUR的术前预测.
背景:中国临床试验注册:ChiCTR2000039684,2020年5月11日。