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摘要: 目的 探讨前列腺穿刺患者术中疼痛的影响因素。方法 回顾性分析2019年3月—2021年11月苏北人民医院收治的628例前列腺穿刺活检患者的临床资料[年龄、前列腺特异性抗原(PSA)、穿刺针数、前列腺体积、视觉模拟量表(VAS)评分、糖尿病史、体重指数、美国东部协作肿瘤组(Eastern Cooperative Oncology Group，ECOG)评分、重大外伤史、手术史、血型]，根据患者穿刺术中的VAS评分(2~7)将患者分为A~F共6组，比较组间数据的差异。结果 入组患者的年龄(P=0.002)、PSA(P < 0.001)、前列腺体积(P < 0.001)、穿刺针数(P < 0.001)、体重指数(P < 0.001)、生活质量评分(P < 0.001)分布均不符合正态分布，组间的年龄(P=0.152)、PSA(P=0.824)、体重指数(P=0.282)、生活质量评分(P=0.244)、手术史(P=0.799)、血型(P=0.376)比较差异无统计学意义，前列腺体积(P < 0.001)、穿刺针数(P < 0.001)、糖尿病史(P < 0.001)、重大外伤史(P=0.023)比较差异有统计学意义。多元线性回归分析提示前列腺体积(t=11.389，P < 0.001)、糖尿病史(t=-3.222，P=0.001)是术中疼痛的主要影响因素，前列腺体积较大、穿刺针数较多的患者VAS评分较高，糖尿病患者、有重大外伤史的患者VAS评分较低。结论 行前列腺穿刺活检时，前列腺体积、穿刺针数与术中疼痛正性相关，糖尿病患病情况、重大外伤经历与术中疼痛负性相关。Abstract: Objective To discuss the influencing factors of intraoperative pain in patients who underwent prostate biopsy.Methods A total of 628 patients who underwent prostate biopsy were analyzed retrospectively from March 2019 to November 2021. The correlation of intraoperative pain with age, PSA, number of cores, prostate volume, visual analog scale(VAS) scores, diabetes history, body mass index, Eastern Cooperative Oncology Group(ECOG) score, serious injury history, operation history, blood type was evaluated. Patients were divided into 6 groups from A to F according to their VAS scores(2-7) during puncture to compare data differences among groups.Results The distribution of age(P=0.002), PSA(P < 0.001), prostate volume(P < 0.001), number of cores(P < 0.001), body mass index(P < 0.001) and quality of life score(P < 0.001) did not conform to normal distribution, and there were no statistical differences in age(P=0.152), PSA(P=0.824), body mass index(P=0.282), quality of life score(P=0.244), operation history(P=0.799) or blood type(P=0.376) among groups. However, there were statistical differences in prostate volume(P < 0.001), number of cores(P < 0.001), diabetes history(P < 0.001) and serious injury history(P=0.023). Multiple linear regression analysis suggested that prostate volume(t=11.389, P < 0.001) and diabetes history(t=-3.222, P=0.001) were the main influencing factors for intraoperative pain. Patients with larger prostate volume or more puncture needles had higher VAS scores, while patients with diabetes or a history of serious injury had lower VAS scores.Conclusion Prostate volume and number of puncture needles were positively correlated with intraoperative pain, while diabetes and a history of serious injury were negatively correlated with intraoperative pain.
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Key words:
- prostate biopsy /
- pain /
- influencing factors
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表 1 各分组组间数据差异性分析
例，M(P25，P75) 项目 A组(292例) B组(90例) C组(64例) D组(110例) E组(50例) F组(22例) P值 年龄/岁 70(63，75) 72(67，77) 69(63，74.5) 71(66，77) 72(68，77) 73(70.5，75) 0.152 PSA/(ng/mL) 13.9 (9.6，25.9) 14.6 (10.1，26.4) 17.3 (10.9，26.5) 14 (11.3，20.0) 12.6 (11.1，22.3) 14.6 (10.3，23.8) 0.824 穿刺针数 20 (18，23) 19 (18，21) 20 (19.5，21) 23 (21，23) 24 (23，24) 25 (24，25) < 0.001 前列腺体积/mL 35.3 (26.3，52.1) 39.1 (33.5，45.1) 46.9 (38.5，56.5) 68.9 (60.4，75.7) 87.4 (80.8，96.7) 107.5 (93.8，128.8) < 0.001 体重指数/(kg/m2) 24.2 (23.1，26.7) 24.2 (23.1，25.0) 23.7 (22.5，24.6) 23.9 (23.0，24.8) 24.2 (22.7，25.7) 23.9 (22.8，24.6) 0.282 ECOG评分 0(0，0) 0(0，1) 0(0，0) 0(0，1) 0(0，0) 0(0，0.5) 0.244 糖尿病史 114 38 8 14 4 2 < 0.001 手术史 84 32 20 28 10 6 0.799 重大外伤史 76 14 8 8 4 4 0.023 血型 0.376 A 104 34 16 28 20 14 B 84 20 24 32 10 0 AB 36 8 4 14 4 6 O 68 28 20 36 16 2 
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表 2 影响因素的多元线性回归分析
自变量 回归系数 标准误差 标准回归系数 t P值 常数项 0.634 0.558 - 1.138 0.256 前列腺体积 0.056 0.003 0.574 11.389 < 0.001 穿刺针数 0.033 0.029 0.094 1.908 0.057 糖尿病史 -0.468 0.145 -0.136 -3.222 0.001 重大外伤史 -0.316 0.168 -0.079 -1.885 0.060
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| 引用本文: |
吴振豪, 丁雪飞, 栾阳, 等. 经会阴前列腺穿刺患者术中疼痛的影响因素[J]. 临床泌尿外科杂志, 2023, 38(9): 681-684. doi: 10.13201/j.issn.1001-1420.2023.09.008
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| Citation: |
WU Zhenhao, DING Xuefei, LUAN Yang, et al. Research on the influencing factors of intraoperative pain in patients with biopsy[J]. J Clin Urol, 2023, 38(9): 681-684. doi: 10.13201/j.issn.1001-1420.2023.09.008
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