经会阴前列腺穿刺活检致感染性休克临床分析  

作　　者：谢玺[1] 王旭亮[1] 王于勇[1] 陈超[1] 何华东[1] 于志坚[1] 

机构地区：[1]杭州市第一人民医院泌尿外科,310000

出　　处：《浙江临床医学》2016年第11期2072-2074,共3页Zhejiang Clinical Medical Journal

摘　　要：目的：探讨直肠超声引导下经会阴前列腺穿刺活检术致感染性休克的临床特点及诊治策略。方法2008年9月至2015年12月超声引导下经会阴改良前列腺穿刺活检1274例，对其中4例感染性休克的患者进行回顾性分析和随访。结果经会阴前列腺穿刺活检术术后出现感染性休克占0.31%，血培养2例为阳性，1例为大肠埃希菌ESBL＋，1例为屎肠球菌VRE；洁尿培养均为阳性，2例为大肠埃希菌ESBL＋，1例为屎肠球菌VRE，1例为粪肠球菌，抢救治疗后均好转出院。结论经会阴前列腺穿刺活检是较为安全的前列腺穿刺方法，但仍可引起感染性休克的严重并发症，致病菌多为大肠埃希菌，也有部分为肠球菌；近年来随着多重耐药细菌的出现，预防控制感染的任务更重要，从而减少感染性休克的发生。Objective To explore the clinical features and treatment strategies of transperineal biopsy of the prostate.Methods A total of 1274 patients were undergone improved transperineal biopsy of the prostate under the direction of tansrectal ultrasound.The clinical data of 4 patients who had suffered from Septic shock were retrospectively analyzed and follow-up from September 2008 to December 2015.Results About 0.31%patients had suffered from Septic shock（4/1274）,we found positive blood culture in 2 cases,E. coli（ESBL＋） in 1 case and enterococcus（VRE） in the other case;Urine culture in 4 cases were all positive,E. coli（ESBL＋） in 2 cases and enterococcus faecium （VRE） in 1 case and enterococcus faecalis in 1 case. 4 cases recovered after treatment.Conclusion Through the retrospective analysis and literature review,transperineal biopsy of the prostate is considered a safe way. On the other hand,it Still can cause serious complications such as Septic shock. As the main culprit,E. coli is one of the Pathogenic bacteria,and there are some enterococcus. To reduce the occurrence of septic shock,the prevention and control are more important with the emergence of multi-resistant bacteria recently.

关 键 词：前列腺穿刺活检 感染性休克 大肠埃希菌 肠球菌 

分 类 号：R473.6[医药卫生—护理学]