膀胱肿瘤经尿道电切术后尿路感染病原菌分析  

Analysis on pathogenic bacteria distribution of urinary tract infections after transurethral resection of bladder tumor

作　　者：范祎[1] 杜军[2] 於裕福[1] 

机构地区：[1]浙江萧山医院泌尿外科,浙江萧山311200 [2]合肥工业大学控释药物研究所,安徽合肥230009

出　　处：《中华医院感染学杂志》2014年第11期2773-2775,共3页Chinese Journal of Nosocomiology

基　　金：安徽省十一五科技基金资助项目(08010302103)

摘　　要：目的探讨经尿道膀胱肿瘤电切术(TURBT)术后患者尿路感染原因,以期为临床TURBT术后尿路感染的预防治疗提供帮助。方法回顾性分析2009年1月-2012年12月行TURBT住院患者的临床资料、尿路感染的发生率及其影响因素、病原菌分布,采用SPSS17.0统计软件进行数据分析。结果 213例行TURBT患者术后发生尿路感染60例,感染率28.17%;共分离出68株病原菌,革兰阴性菌50株占73.5%,革兰阳性菌18株占26.5%,其中以大肠埃希菌最为常见占51.5%,其次是肺炎克雷伯菌和肠球菌属,分别占17.6%、4.4%,未分离出真菌;年龄>60岁、肿瘤位点多发患者、有糖尿病史、术前有留置导管、白细胞数低、术前使用抗菌药物数量少是TURBT术后尿路感染的危险因素(P<0.05),而性别、细胞分型以及慢性支气管炎史对其影响不明显。结论 TURBT术后感染的发生率较高,以革兰阴性菌感染为主,多种相关因素与TURBT术后发生感染有关,性别、细胞分型以及慢性支气管炎史与术后发生感染无显著相关。OBJECTIVE To analyze the situation and causes of urinary tract infections after transurethral resection of bladder tumorr（TURBT）, so as to provide help for the clinical prevention and treatment of urinary tract infections after TURBT. METHODS The relative data of inpatients received TURBT from Jan. 2009 to Dec. 2012 were analyzed retrospectively, including clincial data, the incidence and influence factors of urinary tract infection and the pathogenic bacteria distribution, with statistical software SPSS17.0. RESULTS There were 60 cases in urinary tract infections out of 213 patients who accepted TURBT, and the total incidence rate was 28. 17% totally 68 strains of pathogens were isolated,including gram-negative bacteria（73.5 %） and gram-positive bacteria （26.5%）. The top one species of the pathogens was Escherichia coli （51.5%） ,followed by Klebsiella pneumoniae （17.6~） and Enterococcus（4.4%）,no strains of fungi detected. The risk factors of urinary tract infections after TURBT included elder than 60 years old, multiple tumor sites, diabetes history, preoperative catheter indwelling, low number of white blood cells, and use less antimicrobial drugs（P^0.05）, while gender, cell classification and history of chronic bronchitis were not related to it. CONCLUSION This study confirms that infections occurr after TURBT operation, which is mainly caused by gram-negative bacteria. Many factors are related to postoperative infections after TURBT, while gender, cell classification and history of chronic bronchitis are not obviously related to it.

关 键 词：经尿道膀胱肿瘤电切术 尿路感染 病原菌 临床分析 

分 类 号：R737.14[医药卫生—肿瘤]