上尿路梗阻患者术后感染及应对方式与生活质量的相关性

赵盈盈; 李爽; 张鑫; 高学军; 李涛

doi:10.16766/j.cnki.issn.1674-4152.004145

上尿路梗阻患者术后感染及应对方式与生活质量的相关性

doi: 10.16766/j.cnki.issn.1674-4152.004145

赵盈盈¹,
李爽¹,
张鑫¹,
高学军²,
李涛^1, ,

1.
首都医科大学附属北京朝阳医院泌尿外科，北京 100043
2.
首都医科大学附属北京朝阳医院外科

基金项目:

北京市自然科学基金面上项目 7222073

详细信息

通讯作者:
李涛, E-mail: taoli646@163.com

中图分类号: R694.51
计量
- 文章访问数: 10
- HTML全文浏览量: 6
- PDF下载量: 2
- 被引次数: 0
出版历程
- 收稿日期: 2025-02-11
- 网络出版日期: 2025-10-31

The Correlation among postoperative infection, coping modes, and quality of life in patients with urinary tract obstruction

1.
Department of Urology, Shijingshan District, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100043, China

摘要

摘要: 目的分析上尿路梗阻患者术后感染、应对方式与生活质量的相关性，为术后管理提供依据。方法回顾性分析2022年6月—2024年6月首都医科大学附属北京朝阳医院收治的292例上尿路梗阻患者的临床资料，统计患者术后感染、医学应对方式问卷(MCMQ)和生活质量量表(SF-36)，分析术后感染、应对方式与生活质量的关系。结果 292例上尿路梗阻患者术后感染31例(10.62%)；MCMQ中面对、回避、屈服得分为(24.12±3.41)分、(21.46±3.18)分、(15.63±2.99)分；SF-36中健康感觉维度得分为(72.78±7.07)分，躯体健康维度得分为(72.80±7.95)分，心理功能维度得分为(73.71±7.84)分，物质生活态度维度得分为(74.73±7.18)分，社会功能维度得分为(76.11±7.17)分；相关性分析显示，术后感染与生活质量呈负相关关系(r=-0.447，P=0.003)，MCMQ的面对与生活质量呈正相关关系，回避和屈服与生活质量呈负相关关系(r=0.351、-0.301、-0.374，均P＜0.05)；结构方程模型显示，术后感染可直接影响上尿路梗阻患者生活质量，也可通过面对、回避、屈服应对方式间接影响患者的生活质量；多因素分析表明，年龄、婚姻状况、家庭月收入、其他疾病史、合并感染及应对方式均是影响上尿路梗阻患者生活质量的重要因素(P＜0.05)。结论上尿路梗阻患者的术后感染及应对方式显著影响生活质量，应重点干预患者的术后感染和不良应对方式，以提高其生活质量。
- 上尿路梗阻 /
- 术后感染 /
- 应对方式 /
- 生活质量 /
- 相关性
Abstract: Objective To analyze the correlation among postoperative infection, coping modes, and quality of life in patients with urinary tract obstruction so as to provide a basis for postoperative management. Methods The clinical data of 292 patients with urinary tract obstruction admitted to Beijing Chaoyang Hospital Affiliated to Capital Medical University from June 2022 to June 2024 were retrospectively analyzed. The postoperative infection, medical coping modes questionnaire (MCMQ), and short form 36 questionnaire (SF-36) were recorded. The relationships among postoperative infection, coping modes, and quality of life were analyzed. Results Postoperative infection occurred in 31 (10.62%) of 292 patients with upper urinary tract obstruction. MCMQ scores for confrontation, avoidance, and resignation were (24.12±3.41) points, (21.46±3.18) points, and (15.63±2.99) points, respectively. SF-36 scores of health perception, physical health, mental function, attitude toward material life, and social function were (72.78±7.07) points, (72.80±7.95) points, (73.71±7.84) points, (74.73±7.18) points and (76.11±7.17) points, respectively. Correlation analysis showed that postoperative infection was negatively correlated with quality of life (r=-0.447, P=0.003). Confrontation scores in MCMQ were positively correlated with quality of life, while avoidance and resignation scores were negatively correlated (r=0.351, -0.301, -0.374, respectively, all P < 0.05). The structural equation model showed that postoperative infection directly affected the quality of life of patients with upper urinary tract obstruction, and indirectly affected it through the coping modes of confrontation, avoidance, and resignation. Multivariate analysis showed that age, marital status, family monthly income, comorbidities, co-infection, and coping modes as important factors affecting quality of life (P < 0.05). Conclusion Postoperative infection and coping modes of patients with urinary tract obstruction significantly affect the quality of life. Targeted interventions addressing postoperative infection and adverse coping modes of patients are essential for improving their quality of life.
- Urinary tract obstruction /
- Postoperative infection /
- Coping modes /
- Quality of life /
- Correlation

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表 1 上尿路梗阻患者术后感染、应对方式与生活质量(SF-36)的相关性

Table 1. Correlation between postoperative infection, coping style, and quality of life (SF-36) in patients with upper urinary tract obstruction

项目	MCMQ			术后感染
项目	面对	回避	屈服	术后感染
统计量	0.351^a	-0.301^a	-0.374^a	-0.447^b
P值	0.010	0.018	0.006	0.003
注：^a为r值，^b为r_s值。

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表 2 修正后结构方程模型的各项拟合指标

Table 2. Each fitting index of the modified structural equation model

拟合指标	数值	判断值
χ²/df	2.110	＜3.00
拟合优度指数	0.950	＞0.90
修正拟合优度指数	0.901	＞0.90
增值适配指数	0.965	＞0.90
比较拟合指数	0.964	＞0.90
近似误差均方根	0.075	＜0.08

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表 3 Bootshrap中介效应检验

Table 3. Bootshrap test for mediation effects

效应类型	路径	效应值95% CI	经抽样的SE值	P值	效应量(%)
总效应	术后感染→生活质量	-0.588(-0.665~-0.428)	0.080	＜0.001	100.00
直接效应	术后感染→生活质量	-0.334(-0.463~-0.286)	0.068	＜0.001	56.80
间接效应	术后感染→面对应对→生活质量	-0.135(-0.388~-0.125)	0.064	＜0.001	22.96
	术后感染→回避应对→生活质量	-0.061(-0.229~-0.058)	0.045	＜0.001	10.37
	术后感染→屈服应对→生活质量	-0.058(-0.207~-0.056)	0.042	＜0.001	9.86

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表 4 不同一般资料上尿路梗阻患者SF-36评分比较

Table 4. Comparison of SF-36 scores in patients with upper urinary tract obstruction

项目	例数(%)	SF-36(x ± s，分)	统计量	P值
性别			1.595^a	0.112
男性	216(73.97)	372.65±35.10
女性	76(26.03)	365.11±36.38
年龄(岁)			25.053^b	＜0.001
≤40	92(31.51)	378.91±37.24
41~59	157(53.77)	375.47±35.09
≥60	43(14.73)	335.63±32.04
受教育程度			1.425^b	0.242
初中及以下	135(46.23)	372.94±37.22
中专及高中	102(34.93)	371.58±33.10
大专及以上	55(18.84)	363.50±35.87
婚姻状况			2.328^a	0.021
已婚	181(61.99)	374.48±36.04
未婚/离异/丧偶	111(38.01)	364.50±34.77
家庭月收入(元)			3.987^b	＜0.001
＜3 000	58(19.86)	349.32±32.05
3 000~4 999	70(23.97)	366.78±36.21
5 000~9 999	88(30.14)	377.42±33.48
≥10 000	76(26.03)	382.79±37.50
职业			0.994^b	0.608
工人	110(37.67)	372.01±34.38
农民	36(12.33)	365.20±34.53
干部	46(15.75)	381.54±39.05
其他人员	61(20.89)	367.70±36.74
无业	39(13.36)	363.89±33.99
其他疾病史			4.069^a	＜0.001
有	189(64.73)	364.50±34.37
无	103(35.27)	382.04±36.66
手术类型			1.459^a	0.146
经皮肾镜碎石取石术	190(65.07)	368.47±35.82
输尿管镜下碎石术	102(34.93)	374.82±34.80
术后感染			5.882^a	＜0.001
有	31(10.62)	346.72±33.74
无	261(89.38)	373.53±36.31
注：^a为t值，^b为F值。

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表 5 上尿路梗阻患者生活质量影响因素的多元线性回归分析

Table 5. Multivariate linear regression analysis of factors influencing quality of life in patients with upper urinary tract obstruction

变量	B	SE	B'	t值	P值
年龄	-1.725	0.598	-0.042	-2.893	0.004
婚姻状况	-3.157	1.380	-0.089	-2.288	0.022
家庭月收入	4.299	1.096	0.095	3.922	＜0.001
其他疾病史	4.501	1.579	0.097	2.850	0.005
合并感染	6.717	2.305	0.106	2.914	0.004
MCMQ	7.400	2.734	0.114	2.707	0.008
注：R²=0.791，调整R²=0.727，F=6.709，P＜0.001；年龄(≤40岁=1，41~59岁=2，≥60岁=3)，婚姻状况(已婚=1，未婚/离异/丧偶=2)，家庭月收入(＜3 000元=1，3 000~4 999元=2，5 000~9 999元=3，≥10 000元=4)，其他疾病史(有=1，无=2)，合并感染(有=1，无=2)。MCMQ以实际值赋值。

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