经皮肾镜取石术中肾盂尿培养细菌分析及临床意义  

Analysis of Bacteria in Renal Pelvic Urine Culture During Percutaneous Nephrolithotomy and Its Significance

作　　者：鲁可权[1] 程香玲[1] 黄占苗[1] 许承斌[1] 

机构地区：[1]中国人民解放军九七医院泌尿外科,江苏徐州221004

出　　处：《医学临床研究》2013年第8期1542-1543,1546,共3页Journal of Clinical Research

摘　　要：【目的】探讨经皮肾镜取石（PCNL）术中肾盂尿培养细菌分布及其临床意义。【方法】对408例行经皮肾镜取石术的上尿路结石患者，术前作中段尿培养，术中取肾盂尿作细菌培养和药物敏感试验，分析细菌种类及其耐药谱，比较术后发热的发生率。【结果]408例术前中段尿培养阳性率9．8％（40／408），术中肾盂尿培养阳性率18．4％（75／408），两组阳性率比较有显著性差异（P〈0．05）；培养细菌以大肠埃希菌、葡萄球菌属、变形杆菌属为主；肾盂尿培养阳性者与阴性者，术后发热比率分别为为49．3％（37／75）和12．6％（42／333），两者有显著差异（Pd0．05）。【结论]PCNL术中肾盂尿培养阳性对预测患者术后发热有重意义，肾盂尿细菌培养及药敏试验有助于其临床处理和合理应用抗生素。[Objective] To explore the bacterial distribution of renal pelvic urine culture during percutane- ous nephrolithotomy（PCNL） and its significance. [Methods] Totally 408 patients with upper urinary tract cal- culi undergoing PCNL were enrolled in the study. Mid-stream urine culture before operation and intraoperative renal pelvic urine culture were carried for bacterial culture and susceptibility test. The bacteria types and anti- biotic resistance spectrum were analyzed. The incidence of postoperative fever was compared. I^Results] A- mong 108 patients, the positive rate of pre-operative mid-stream urine culture was 9.8% （40/408）, while the positive rate of intraoperative mid-stream renal pelvic urine culture were 18.4% （75/408）, and there was sig- nificant difference（ P 〈0.05）. The predominant bacteria were Escherichia coli, Staphylococcus and Proteus. The post-operative fever ratios of patients with positive and negative renal pelvic urine culture were 49. 3% （37/75） and 12.6 % （42/333） respectively, and there was significant difference（ P 〈0.05）. [Conclusion] The positive intraoperative renal pelvic urine germiculture has important significance for predicting the occurrence of fever of patients after PCNL. Renal pelvic urine culture and bacterial susceptibility test are helpful for clini- cal treatment and rational selection of antibiotics.

关 键 词：肾造口术 经皮 

分 类 号：R692.4[医药卫生—泌尿科学]