Zaheer S, Reilly W T, Pemberton J H, Ilstrup D
Division of Colon & Rectal Surgery, Mayo Clinic and Mayo Foundation, Rochester, Minnesota 55905, USA.
Dis Colon Rectum. 1998 Jun;41(6):696-704. doi: 10.1007/BF02236255.
This study was undertaken to determine the incidence and risk factors for urinary retention after operations for benign anorectal diseases.
We reviewed 1,026 consecutive operations for benign anorectal diseases from 1989 to 1994. Risk factor analysis was done for patients undergoing hemorrhoidectomy (Group I) and other procedures (Group II) using logistic regression analysis.
The number of procedures and urinary retention rate was as follows: 344 (34 percent) hemorrhoidectomies, 159 (2 percent) fistulotomies, 95 (5 percent) incision/drainage, 247 (4 percent) lateral internal sphincterotomy, 181 (17 percent) combinations of the above four procedures, and overall 1,026 (16 percent). In Group I, four-quadrant excision (odds ratio, 3.3; P = 0.0004), three quadrant excision (odds ratio, 2.4; P = 0.003), morphine equivalents >33 (odds ratio, 1.8; P = 0.01), and male gender (odds ratio, 1.7; P = 0.02) were independent risk factors. In Group II, more than one operation (odds ratio, 3.0; P = 0.004), older age (odds ratio, 3.1; P = 0.005), intraoperative fluids (odds ratio, 2.6; P = 0.03), and postoperative fluids (odds ratio, 2.7; P = 0.02) were independent risk factors. Urinary obstructive symptoms for both groups and perioperative fluids for Group I were NOT independent risk factors. Hospital stay was prolonged significantly in patients with urinary retention (P = 0.0001).
Urinary retention is a common postoperative complication that increases hospital stay. It is most common after hemorrhoidectomy. Disease severity (quadrants excised and analgesia requirement for Group I and number of operations for Group II) is an important risk factor for both groups studied. Older age in Group I and perioperative fluid in Group II may be important risk factors.
本研究旨在确定良性肛肠疾病手术后尿潴留的发生率及危险因素。
我们回顾了1989年至1994年连续进行的1026例良性肛肠疾病手术。采用逻辑回归分析对接受痔切除术的患者（第一组）和其他手术的患者（第二组）进行危险因素分析。
手术例数及尿潴留率如下：痔切除术344例（34%），肛瘘切开术159例（2%），切开引流术95例（5%），内括约肌侧切术247例（4%），上述四种手术联合181例（17%），总计1026例（16%）。在第一组中，四象限切除术（比值比，3.3；P = 0.0004）、三象限切除术（比值比，2.4；P = 0.003）、吗啡当量>33（比值比，1.8；P = 0.01）及男性（比值比，1.7；P = 0.02）为独立危险因素。在第二组中，不止一项手术（比值比，3.0；P = 0.004）、年龄较大（比值比，3.1；P = 0.005）、术中补液量（比值比，2.6；P = 0.03）及术后补液量（比值比，2.7；P = 0.02）为独立危险因素。两组的尿路梗阻症状及第一组的围手术期补液量并非独立危险因素。尿潴留患者的住院时间显著延长（P = 0.0001）。
尿潴留是一种常见的术后并发症，会延长住院时间。它在痔切除术后最为常见。疾病严重程度（第一组的切除象限数和镇痛需求以及第二组的手术次数）是所研究的两组的重要危险因素。第一组的年龄较大及第二组的围手术期补液量可能是重要危险因素。
