抗生素对经直肠前列腺活检术后感染并发症预防效果的Meta分析  

Meta-analysis of prophylaxis value of antibiotic in preventing infection complications after transrectal prostatic biopsy

作　　者：杨明根[1] 赵晓昆[1] 吴志平[1] 侯轶[1] 肖宁[1] 吕晨[1] 

机构地区：[1]中南大学湘雅二医院泌尿外科,长沙410011

出　　处：《中国男科学杂志》2009年第2期17-23,共7页Chinese Journal of Andrology

摘　　要：目的分析预防性抗生素能否减少术前为清洁尿、行经直肠前列腺活检术(TPB)患者的术后感染并发症。方法制定原始文献的纳入标准、排除标准及检索策略,在MEDLINE(1966年1月—2007年12月)、EMBASE(1988年1月—2007年12月)、Cochrane Collaboration Reviews(1993年1月—2007年12月)、中国生物医学期刊文献数据库(CMCC,1979年—2007年12月)、CNKI数字图书馆(1979年1月—2007年12月)进行相关的随机对照试验(RCT)的检索、质量评价和资料提取,采用Rev Man 4.2软件进行Meta分析。结果共检索到相关随机对照试验68篇,排除57篇,符合纳入标准11篇进入Meta分析。结果表明:术前清洁尿的患者,预防性抗生素能显著降低TPB术后1周内菌尿和术后发热的比率,疗效分析相对危险度(RR值)及其95%CI分别为0.36(0.25～0.52)和0.39(0.24～0.63),但不能减少菌血症的发生率,RR值及其95%CI为0.92(0.57～1.48);各疗程预防性抗生素能明显减少TPB术后菌尿的发生率;喹诺酮及喹诺酮联合硝基咪唑均能明显降低TPB术后发生菌尿的危险。结论术前为清洁尿的患者,预防性应用抗生素能减少TPB术后菌尿和发热的发生率,但不能降低菌血症的发生率;喹诺酮及喹诺酮联合硝基咪唑均能明显降低TPB术后发生菌尿的危险;各疗程预防性抗生素能明显减少TPB术后菌尿的危险。Objective To analyze whether the risk of postoperative infection complications in patients underwent TPB who had preoperative sterile urine can be reduced with antibiotic. Methods Papers in database of MEDLINE, EMBASE, Cochrane Collaboration Reviews, CMCC and CNK1 were searched for RCTs analysis. The search strategy was made according to the Collaborative Review Group search strategy. Data were extracted by two reviewers using the designed table. Review management and data analysis were done by software RevMan4.2. Results Sixty-eight studies with relevant RCTs were found, and 11 of which were enrolled in Meta-analysis. Antibiotic use significantly reduced the incidence of post-TPB bacteria-urian and post-TPB fever, but the incidence of post-TPB bacteremia was not changed, and. the corresponding pooled relative risk （RR） and 95%CI was 0.36（0.25-0.52）,0.39（0.24-0.63）and 0.92 （0.57-1.48） respectively. Antibiotics including quinolones and quinolones combining nitroimidazole were found to be effective. Conclusion Antibiotic use can significantly prevent the incidence of infection complications after transrectal prostatic biopsy.

关 键 词：前列腺 活组织检查 抗生素预防 系统评价 META分析 

分 类 号：R697.3[医药卫生—泌尿科学]