临床外科杂志 ›› 2026, Vol. 34 ›› Issue (3): 331-336.doi: 10.3969/j.issn.1005-6483.20250230

• 论著 • 上一篇    下一篇

经尿道膀胱肿瘤切除术后尿道感染的病原菌特点及风险预测模型

杨晓伟 王雷雨 胡春晖 赵先诚 邓鑫 张前进   

  1. 223800 江苏宿迁,江苏省人民医院宿迁医院/宿迁市第一人民医院泌尿外科
  • 收稿日期:2025-03-13 出版日期:2026-05-08 发布日期:2026-05-08
  • 通讯作者: 张前进,Email:qjqj198703161@163.com
  • 基金资助:
    江苏省卫生健康委员会面上项目(MQ2024028)

Pathogen characteristics and risk prediction model of urethral infection after transurethral bladder tumor resection

YANG Xiaowei,WANG Leiyu,HU Chunhui,ZHAO Xiancheng,DENG Xin,ZHANG Qianjin   

  1. Department of Urology,Suqian Hospital of Jiangsu Provincial People's Hospital/ Suqian First Hospital,Suqian 223800,China
  • Received:2025-03-13 Online:2026-03-20 Published:2026-05-08

摘要: 目的 探讨膀胱癌病人经尿道膀胱肿瘤切除术后尿道感染的病原菌特点及风险预测模型。方法 2022年1月~2024年12月收集的膀胱癌病人150例,均行经尿道膀胱肿瘤切除术。根据病人术后是否发生尿道感染,将病人分为两组,未感染组127例,感染组23例,采用单因素初步筛选可能影响膀胱癌病人术后发生尿道感染因素,根据单因素筛查结果,进行多因素logistics回归确定独立影响因素,使用R软件构建膀胱癌病人术后尿道感染预测模型,计算曲线下面积(AUC)、敏感性和特异性,评估预测模型的性能。结果 150例病人出现尿道感染23例,在感染病例中,革兰阴性菌感染16例(占69.57%)。单因素分析结果显示,年龄、糖尿病史、盆腔放疗史、手术时间、导尿管留置时间与病人术后发生尿道感染有相关性(P<0.05)。将单因素分析有差异指标纳入二元Logistic回归模型分析,结果表明,合并糖尿病、盆腔放疗史、年龄较大、导尿管留置时间长是影响膀胱癌病人经尿道膀胱肿瘤切除术后尿道感染的独立危险因素(P>0.05)。基于上述独立影响因素,建立列线图模型,C-index为0.99,表明其具有很好的区分度,模型实际观测值与预测值无显著差异(χ2=8.999,P=0.3424),提示模型拟合度良好,预测模型的AUC为0.977,95%CI为0.952~1.000,进一步证实了模型的准确性。结论 膀胱癌病人经尿道膀胱肿瘤切除术后发生尿道感染的几率较高,主要以革兰阴性菌为主。尿道管留置时间过长、年龄、盆腔放疗史、糖尿病史为尿路感染的重要风险因素,针对危险因素采取针对性预防措施,可降低感染率。

关键词: 膀胱癌; 经尿道膀胱肿瘤切除术; 尿道感染; 病原菌; 风险预测

Abstract: Objective To explore the pathogen characteristics and risk prediction model verification of urinary tract infection after transurethral bladder cancer tumor resection.Methods This study adopted a retrospective analysis method to conduct an in-depth analysis of the data from 150 bladder cancer patients collected by our hospital between January 2022 and December 2024.Patients were divided into two groups based on whether they developed urinary tract infections post-surgery:the non-infected group (n=127) and the infected group (n=23).A preliminary single-factor screening was conducted to identify potential factors that may influence the occurrence of urinary tract infections in bladder cancer patients after surgery.Based on the results of the single-factor screening,a multivariate logistics regression was performed to determine independent influencing factors.The R software was used to construct a predictive model for postoperative urinary tract infections in bladder cancer patients,and the area under the curve (AUC),sensitivity,and specificity were calculated to evaluate the performance of the predictive model.Results In 150 bladder cancer patients,23 cases developed urinary tract infections.Among these infected cases,Gram-negative bacteria accounted for 16 cases,representing as high as 69.57%.Univariate analysis showed that age,history of diabetes,pelvic radiation therapy,surgery duration,and catheter retention time were significantly associated with postoperative urinary tract infections (P<0.05).Variables with significant differences were included in a binary Logistic regression model,which identified diabetes,history of pelvic radiation therapy,older age,and longer catheter retention time as independent factors influencing urinary tract infections after transurethral resection of bladder tumors in bladder cancer patients(P>0.05).Additionally,based on these independent influencing factors,a logistic regression model was established with an C-index of 0.99,indicating excellent discrimination.There was no significant difference between the actual observed values and predicted values (χ2=8.999,P=0.342 4),suggesting good model fit.The AUC of the predictive model was 0.977,with a 95%CI ranging from 0.952 to 1.000,further confirming the accuracy of the model.Conclusion Patients with bladder cancer have a higher chance of developing urinary tract infections after transurethral resection of bladder tumors,primarily due to Gram-negative bacteria.Further analysis revealed that prolonged catheterization,age,history of pelvic radiation therapy,and diabetes are significant risk factors for urinary tract infections.Targeted preventive measures for these risk factors can reduce infection rates and improve patient outcomes.

Key words: bladder cancer; transurethral bladder tumor resection; urinary tract infection; pathogenic bacteria; risk prediction

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