无危险因素患者体外碎石后出现感染并发症的前瞻性研究  

Prospective investigation of infectious incidence after shock wave lithotripsy in patients without risk factors

作　　者：李冬霞[1] 郑浩[1] 郑小青[1] 韦胜威[1] 

机构地区：[1]中山大学附属第五医院泌尿外科,广东珠海519000

出　　处：《岭南现代临床外科》2016年第5期601-604,共4页Lingnan Modern Clinics in Surgery

摘　　要：目的探讨无危险因素的病人在体外冲击波碎石术（ESWL）后感染并发症的发生率及预防性使用抗生素的必要性。方法纳入2011年5月~2014年8月的患者进行前瞻性队列研究。将无明确相关危险因素并接受体外碎石的肾结石或输尿管结石患者纳入。患者分别于碎石的3天前及7天后作尿培养。没有对患者使用抗生素。结果共122名患者（52±10岁）纳入研究范围。总共9名患者（7.4%）体外碎石前留置了双J管,7名（6.1%）患者碎石术后尿培养结果阳性,1名（0.87%）出现了尿路感染的症状,其余患者无症状,尿脓毒症并未出现。Logistive回归分析显示患者的年龄是术后菌尿的独立危险因素。结论对于没有危险因素的患者来说,碎石后发生感染的风险较低,预防性使用抗生素是不必要的,但年长患者例外。Objective To investigate the infectious complications of extraeorporeal shock wave lithotripsy in patients without associated risk factors. Methods We performed a prospective cohort study between March 2011 and August 2014. The patients who subjected to extracorporeal shock wave lithotripsy and were not found infectious risk factors were included in the study. All patients underwent urine culture three days before the procedure and seven days after lithotripsy. No patient received antibiotics. Results 122 patients with a mean age of 52_＋10 years met inclusion criteria. A total of nine patients （7.4%） underwent extracorporeal shock wave lithotripsy with a previously placed Double- J stent. After lithotripsy urine culture was positive in seven patients （6.1%）, of whom one （0.87%） presented with symptomatic urinary infection and the remaining showed no symptoms. Urosepsis did not develop in any case. The age in the patient was an independent risk factor for bacteriuria after lithotripsy. Conclusion The incidence of infectious complications after extracorporeal shock wave lithotripsy in patients without risk factors is low. This leads us to conclude that without defined risk factors antibiotic prophylaxis is not justified. Elder patients were more at risk for baeteriuria after extracorporeal shock wave lithotripsy and more at risk developing infectious complications.

关 键 词：肾 输尿管 碎石 抗生素 尿石症 

分 类 号：R693.4[医药卫生—泌尿科学]