经尿道前列腺切除术后尿路感染的相关因素  

Related factors for urinary tract infections after transurethral resection of prostate

作　　者：沈玲[1] 王旭亮[1] 李莉[1] 

机构地区：[1]杭州市第一人民医院泌尿外科,浙江杭州310006

出　　处：《中华医院感染学杂志》2013年第24期6035-6037,共3页Chinese Journal of Nosocomiology

基　　金：杭州市卫生科技计划基金项目(2011A013)

摘　　要：目的探讨经尿道前列腺切除术后尿路感染的危险因素,并采取相对应的处理措施,以提高临床治疗水平。方法回顾性分析2009年1月-2011年1月150例经尿道前列腺切除术患者,对其中17例术后出现尿路感染患者进行危险因素分析。结果 150例经尿道前列腺切除术后尿路感染17例,发生率为11.33%;其危险因素有高龄(>70岁)、糖尿病、术前导尿、术前未应用抗菌药物、术后留置导尿时间长(>5d)、手术时间长(>1h)、低蛋白血症、住院时间长(>7d)等(P<0.05),而与术者操作程度、高血压病、肺部疾病等无关(P>0.05);其中术前导尿、低蛋白血症、糖尿病、术后留置导尿时间、预防应用抗菌药物是高危险因素(P<0.05),检出病原菌以大肠埃希菌为主,占42.86%,大肠埃希菌对美洛西林、青霉素、阿米卡星、环丙沙星耐药率较高,分别为77.8%、66.7%、66.7%、55.6%,对美罗培南、亚胺培南、头孢曲松耐药率较低,均<25.0%;金黄色葡萄球菌及肠球菌属对青霉素、氨苄西林的耐药率均>50.0%,未检出对亚胺培南及美罗培南耐药菌株。结论充分做好经尿道前列腺切除术围手术期工作,可有效降低术后尿路感染的发生。OBJECTIVE To investigate the risk factors of urinary tract infections after transurethral resection and take corresponding measures so as to improve the level of clinical treatment. METHODS A retrospective analysis was performed for 150 cases of patients who underwent the transurethral resection from Jan. 2009 to Jan. 2011, then the risk factors for the postoperative urinary tract infections in 17 cases were analyzed. RESULTS Among 150 cases of patients undergoing transurethral resection, 17 cases had urinary tract infections, accounting for 11.33 % ; the risk factors included the advanced age （more than 70 years）, diabetes, preoperative catheterization, without use of antibiotics before operation, long time retention catheterization after operation （more than 5 days）, long operation duration （more than 1 h）, hypoalbuminemia, and long hospitalization duration （more than 7 d） （P〈0.05）, while the incidence of the postoperative urinary tract infections was not related to the operation level, hypertension, or pulmonary diseases（P〉0. 05）. Preoperative catheterization, hypoalbuminemia, diabetes, length of postoperative catheterization, and prophylactic use of antibiotics were the high risk factors （P〈0.05）. The most common pathogenic bacteria were Escherichia coli, accounting for 42.86%. The drug resistance rates of E. coli to mezlocillin, penicillin, amikacin, and ciprofloxacin were 77.8%, 66.7%, 66.7% , and 55.6%, respectively, while the drug resistance rates to meropenem, imipenem ,and ceftriaxone were less than 25.0%; the drug resistance rates of Staphylococcus aureus and Enterococcus to penicillin and ampicillin were higher than 50.0%, and no strains resistant to imipenem or meropenem were detected. CONCLUSION To fully prepare for the perioperative work of transurethral resection of the prostate can effectively reduce the incidence of postoperative urinary tract infection.

关 键 词：经尿道前列腺切除术 尿路感染 危险因素 干预对策 

分 类 号：R691.3[医药卫生—泌尿科学]