混合痔外剥内扎切除术后发生尿潴留的危险因素及其预测模型的构建

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Abstract Objective To investigate the risk factors of urinary retention after external stripping and internal ligation of mixed hemorrhoids and to construct a prediction model. Methods Clinical data of 532 patients with mixed hemorrhoids who underwent external stripping and internal ligation treatment at the 908th Hospital of PLA Joint Logistics Support Force from December 2018 to November 2023 in our hospital were collected, and the patients were categorized into urinary retention group (n=62) and non-urinary retention group (n=470) according to whether urinary retention occurred after surgery. The optimal cut-off values of each factor were analyzed by receiver operating characteristic (ROC) curve. logistic multiple regression model was used to analyze the independent risk factors for the occurrence of urinary retention after external stripping and internal ligation of mixed hemorrhoids and to construct a prediction model, the correction curve was used to internally validate the prediction model, and decision curve was used to assess the predictive efficacy of the prediction model. Results There was no statistically significant difference between the two groups in terms of gender, BMI, marital status, and anal fissure (P>0.05); the age, proportion of comorbid diabetes mellitus, proportion of epidural anesthesia, proportion of constipation, HAMA score, VAS score, number of points of ligated internal hemorrhoids, and operative time of the urinary retention group were higher than those of the non-urinary retention group, and the difference was statistically significant (P＜0.05). ROC curve analysis showed that the optimal cut-off values for age, HAMA score, VAS score, number of points for lancing internal hemorrhoids, and operative time were 60 years, 13 points, 6 points, 3, and 40 min, respectively. Logistic multiple regression model showed that age (>60 years), comorbid diabetes mellitus (yes), constipation (yes), HAMA score (>13), VAS score (>6), and operative time (>40 min ) were the independent risk factors for the development of urinary retention after the excision of mixed hemorrhoids (P＜0.05).Internal validation showed that the C-index of the prediction model for predicting the occurrence of urinary retention after the excision of mixed hemorrhoids was 0.957 (0.929-0.985). The agreement between observed and predicted values was good. The prediction model predicted a threshold of >0.22 for the occurrence of urinary retention after external and internal ligation excision of mixed hemorrhoids, and the prediction model provided a net clinical benefit over age, comorbid diabetes, constipation, HAMA score, VAS score, and operative time. Conclusions In this study, a prediction model is constructed to predict the occurrence of urinary retention after external stripping and internal ligation of mixed hemorrhoids based on age, comorbid diabetes mellitus, constipation, HAMA score, VAS score, and operation time, which has a good predictive value for the occurrence of urinary retention after the resection, and can provide a basis for clinical improvement of patients’ prognosis.

Key words： mixed hemorrhoid external stripping and internal ligation urinary retention risk factor prediction model

Received: 10 April 2024

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R657.18

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	Articles by authors
	CHEN Xiaoming
	HU Rao
	WAN Shun
	PENG Hong
	CHEN Guilin

Cite this article:

CHEN Xiaoming,HU Rao,WAN Shun等. Risk factors of urinary retention after external stripping and internal ligation of mixed hemorrhoids and construction of a prediction model[J]. Med. J. Chin. Peop. Armed Poli. Forc., 2024, 35(7): 602-606.

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https://journal08.magtechjournal.com/Jwk_wjyx/EN/ OR https://journal08.magtechjournal.com/Jwk_wjyx/EN/Y2024/V35/I7/602

[1]	马咏梅.人文关怀护理对混合痔手术患者术后疼痛及排尿功能的影响分析[J]. 婚育与健康,2024,30(4): 133-135.
[2]	孙玉敏,石健,陈灿,等. 硝酸甘油软膏联合九华痔疮栓治疗混合痔患者术后疼痛的疗效观察[J]. 中医药临床杂志, 2024,36(3):544-547.
[3]	乐国华,郑璐.二点与四点牵引法在重度混合痔患者吻合器痔上黏膜环切术中的应用效果对比[J].中国医学创新,2023,20(31):55-59.
[4]	韩先龙,蒲敏,苏昕,等.盐酸氯普鲁卡因联合布比卡因治疗择期混合痔切除术后尿潴留患者的临床研究[J].中国临床药理学杂志,2023,39(24):3598-3602.
[5]	唐晓璐,刘海燕,张明敏.不同时间按摩结合穴位注射对预防混合痔术后病人尿潴留的效果[J].护理研究, 2020,34(17): 3182-3184.
[6]	Shang J, Kulabieke D, Zhu J, et al. Prognostic factors, treatment decisions, and nomograms for patients with second primary lung cancer following colorectal cancer: a population-based study [J]. Updates Surg, 2023,75(7):1827-1842.
[7]	汤毓华,张明园. 汉密顿焦虑量表(HAMA)[J].上海精神医学,1984(2):64-65.
[8]	孙兵,车晓明. 视觉模拟评分法(VAS)[J]. 中华神经外科杂志,2012,6(28):645.
[9]	刘少鹏,尹洪娜,孙晓蓓,等.近五年针灸防治肛肠疾病术后尿潴留的临床研究进展[J].中国中医急症, 2021, 30(12): 2245-2248.
[10]	朱琳华,张园园,陈晓青.葱白穴位贴敷联合艾灸预防人工关节置换术后尿潴留的效果观察[J].中华老年骨科与康复电子杂志,2018,4(6):331-335.
[11]	赵云霞,王萌,刘万霞,等.济生肾气丸联合针刺治疗老年男性卒中后尿潴留的临床效果[J].实用中医内科杂志,2023,37(11):130-132.
[12]	Hiraki M, Tanaka T, Sadashima E, et al. The risk factors of acute urinary retention after laparoscopic colorectal cancer surgery in elderly patients receiving epidural analgesia [J]. Int J Colorectal Dis, 2021, 36(9): 1853-1859.
[13]	赵鑫,韩威,刘鹏,等.腹腔镜下腹股沟疝修补术后尿潴留发生特征及影响因素分析[J].中国煤炭工业医学杂志,2018,21(4): 398-402.
[14]	殷燕,何文斌,段静,等.结直肠癌术后患者拔除导尿管后发生尿潴留的影响因素分析[J].结直肠肛门外科,2021,27(5):511-514.
[15]	秦凯健,陈新静,施兵,等.混合痔外剥内扎术后发生尿潴留的危险因素分析[J].浙江医学,2018,40(21):2363-2364.
[16]	夏秀芳,张静,苏高莉,等.妇科阴式手术后尿潴留影响因素分析及预测模型构建[J].中国计划生育和妇产科,2021,13(6):85-88.
[17]	云红梅,刘思泰,赵晴,等.宫颈癌术后尿潴留的危险因素分析及临床干预对策[J].川北医学院学报,2019,34(5):656-658.
[18]	韩菁,许晓洁,潘琼.肛肠病术后尿潴留危险因素及中医综合干预预防效果分析[J].辽宁中医药大学学报,2019,21(5):207-210.
[19]	张含郁. 复杂性肛瘘患者术后尿潴留发生状况及其影响因素[J].河南医学研究,2021,30(9):1643-1644.
[20]	张丽娜,倪敏,李明,等.情志疗法联合耳穴揿针在混合痔术后尿潴留中的应用[J].安徽医药,2021,25(8):1549-1553.