聚维酮碘膀胱灌注预防经尿道前列腺切除术后尿路感染的疗效观察  

The effect of povidone-iodine bladder irrigation for prevention of urinary tract infection in patients after TURP

作　　者：刘奔[1] 辛旺[1] 张春阳[1] 盛玉文[1] 高凡[2] 韩立维[2] 

机构地区：[1]辽宁医学院附属第一医院泌尿外科,辽宁锦州121001 [2]辽宁医学院第五临床医院暨锦州市中心医院泌尿外科,辽宁锦州121001

出　　处：《中国现代医学杂志》2013年第6期85-88,共4页China Journal of Modern Medicine

基　　金：辽宁省教育厅资助项目(No:2009A444)

摘　　要：目的探讨聚维酮碘膀胱灌注预防经尿道前列腺切除术后尿路感染的疗效。方法 120例经尿道前列腺切除术患者随机分为2组,各60例。2组在年龄、术前合并症、留置尿管时间、前列腺大小及前列腺症状评分等方面差异无显著性(P>0.05)。2组均行经尿道双极等离子前列腺电切术,在电切前5 min,试验组由尿道口注入0.25%PVP-I溶液20 mL,对照组注入生理盐水20 mL。观察并比较2组术后血液白细胞升高、发热、尿道疼痛、膀胱痉挛、血尿、附睾睾丸炎症、拔除尿管后当日尿常规、中段尿细菌培养等情况。结果 120例患者中,术前稀PVP-I溶液膀胱灌注组术后第一日白细胞升高的比例为19/60,而对照组为30/60,差异有显著性(P=0.0411)。两组间术后发热、尿道疼痛、膀胱痉挛、严重血尿、附睾睾丸炎、拔除尿管后尿WBC≥10/HP及尿细菌培养阳性的例数的差异无显著性。42例术前留置尿管的患者中,术前稀PVP-I溶液膀胱灌注组术后第一日白细胞升高、发热、拔除尿管后尿WBC升高及尿细菌培养阳性的比例分别为9/22、5/22、6/22、2/22;而对照组相应比例分别为15/20、12/20、12/20、8/20,差异有显著性(P值均<0.05)。结论对于术前留置尿管的患者,术前行PVP-I溶液膀胱灌注可明显降低术后尿路感染的发生率;对于术前无留置导尿的患者,术前则不必行PVP-I溶液膀胱灌注。【Objective】 To evaluate the clinical efficacy of intravesical therapy with povidone-iodine for the prevention of urinary tract infection after transurethral resection of prostate.【Methods】A total of 120 patients were divided into two groups randomly,each contains 60 cases.There are no significant difference between these two groups on age,preoperative complications,indwelling catheter time,prostate size and prostate symptom scores.Treatment group were irrigated bladder and urethra with 0.25% PVP-I 20 mL 5min before transurethral plasmakenitic of prostate（TUPKP） in contrast that the control group were given normal saline 20 mL.Compare the index of WBC,fever,urethral pain,cystospasm,hematuria,epididymo-orchitis,URme and germ culture of urine after operation between two groups.【Results】Among the 120 cases,the proportion of leukocyte increased more at the first day after TUPKP in control group which was 30/60.In contrast,it was 19/60 in treatment group（P =0.0411）.There were no significant difference between these two groups in the proportion of fever,urethral pain,cystopasm,hematuria,epididymo-orchitis,LEU ≥10/HP,positive in germiculture of urine after operation.In 42 cases of preoperative patients with indwelling catheter,the proportion of the treatment group on leukocyte increase of the first day after TUPKP,fever,LEU≥10/HP and positive in germiculture of urine was 9/22,5/22,6/22,2/22 respectively.Compared with the control group the proportion in control group wan 5/20,12/20,12/20,8/20.There was difference between the two groups in every aspect（P 0.05）.【Conclusion】 In patients with indwelling catheter before operation treated with PVP-I before TUPKP could reduce the incidence of urinary tract infection obviously.There is no need to give intravesical therapy with PVP-I in patients without indwelling catheter before operation.

关 键 词：尿路感染 经尿道前列腺电切术 聚维酮碘 

分 类 号：R697.3[医药卫生—泌尿科学]