【摘要】 目的 分析≥70岁良性前列腺增生（BPH）患者经尿道微创手术后住院期间并发症风险影响因素，构建相关临床预测模型，为优化临床防治策略提供参考依据。方法 回顾性纳入2020年1月至2025年5月于阜阳市第二人民医院接受经尿道前列腺电切或剜除手术治疗且≥70岁BPH患者221例，根据术后住院期间是否发生并发症分为并发症组（41例）和无并发症组（180例）。利用单因素以及多因素分析的方法分析手术后住院期间并发症发生的独立影响因素。利用多因素分析的结果构建手术后住院期间并发症发生风险预测模型，对模型的预测效能进行分析。结果 221例患者术后住院期间发生并发症41例，发生率为18.55%，包括出血15例、泌尿系统感染10例、心血管疾病9例、呼吸困难3例、低钾血症2例、尿潴留1例、深静脉血栓1例；根据Clavien-Dindo分级划分，Ⅰ级7例，Ⅱ级30例，Ⅲ级3例，Ⅳ级1例。单因素以及多因素分析结果显示，前列腺组织切除量、是否合并糖尿病、术前是否尿潴留、术前是否泌尿系统感染、术式、手术时长及术后留置导尿时间是术后住院期间并发症发生的独立影响因素（P<0.05）。利用各独立影响因素构建列线图模型，使用该列线图模型针对本次研究的221例患者完成内部验证，另外选择2017年1月至2019年12月在阜阳市第二人民医院就诊的109例患者的数据实施外部验证，利用受试者工作特征（ROC）曲线对列线图的预测效能实施分析，结果显示内部验证和外部验证的ROC曲线下面积分别为0.977、0.794。结论 ≥70岁BPH患者经尿道微创手术后是否发生并发症与前列腺组织切除量、合并糖尿病情况、术前尿潴留或泌尿系统感染情况、术式、手术时长及术后留置导尿时间等因素关系密切；利用以上因素构建的列线图预测模型对于患者的并发症发生情况预测显示出良好的效能，值得在临床中进一步应用验证。更多还原

【Abstract】 Objective To analyze the influencing factors of complication risk in patients aged 70 years old or older with benign prostatic hyperplasia(BPH) after minimally invasive transurethral surgery, and to further construct a corresponding clinical risk prediction model to guide the formulation of optimized clinical prevention and treatment strategies.Methods A total of 221 patients aged 70 years old or older with BPH who underwent transurethral resection or enucleation of the prostate at our hospital from January 2020 to May 2025 were retrospectively enrolled. According to the occurrence of complications during postoperative hospitalization, they were classified into the complication group(n= 41) and the non-complication group(n=180). Univariate and multivariate analyses were performed to identify independent risk factors for in-hospital complications after transurethral minimally invasive surgery in elderly patients with BPH. Based on the results of multivariate analysis, a risk prediction model was constructed, and its predictive performance was evaluated.Results Among the 211 patients, 41 developed postoperative in-hospital complications, with an incidence of 18. 55%, including bleeding(15 cases), urinary tract infection(10 cases), cardiovascular events(9 cases), dyspnea(3 cases), hypokalemia(2 cases), urinary retention(1 case), and deep vein thrombosis(1 case). According to the Clavien-Dindo classification, there were 7 cases of grade Ⅰ,30 cases of grade Ⅱ, 3 cases of grade Ⅲ and 1 case of grade Ⅳ． Univariate and multivariate analyses showed that prostate tissue resection volume, presence of diabetes mellitus, preoperative urinary retention, preoperative urinary tract infection,surgical procedure, operative time, and postoperative catheterization duration were independent risk factors for in-hospital complications in patients aged ≥ 70 years with BPH(P< 0. 05). A nomogram model was constructed based on the independent risk factors, and internal validation was conducted using the data of the 221 patients included in this study. In addition, external validation was conducted using the data from 109 patients treated at our hospital from January 2017 to December 2019. Receiver operating characteristic(ROC) curve analysis demonstrated that the area under the curve(AUC)was 0. 977 for internal validation and 0. 794 for external validation.Conclusion The occurrence of in-hospital complications after transurethral minimally invasive surgery in patients aged ≥70 years with BPH is closely associated with prostate tissue resection volume, comorbid diabetes mellitus, preoperative urinary retention or urinary tract infection, surgical procedure,operative time, and postoperative catheterization duration. The nomogram prediction model constructed based on these factors shows good predictive performance and is worthy of further clinical application and validation.更多还原