老年前列腺增生症术后尿路感染以及细胞炎性机制分析  

Analysis of urinary tract infection and cellular inflammatory mechanism in elderly patients with prostatic hyperplasia

作　　者：王美才[1] 储传敏 程文 蒋立桂 时进[1] 严浩[1] WANG Meicai;CHU Chuanmin;CHENG Wen(Department of Urology Surgery,Shuyang Central Hospital Suqian,Jiangsu,Suqian 223600,China)

机构地区：[1]江苏省宿迁沭阳县中心医院泌尿外科,223600 [2]海军军医大学第三附属医院泌尿外科 [3]东部战区总医院泌尿外科

出　　处：《临床外科杂志》2020年第11期1066-1069,共4页Journal of Clinical Surgery

摘　　要：目的探讨老年前列腺增生症术后尿路感染以及细胞炎性机制。方法 2016年10月~2019年10月收治的老年前列腺增生病人186例,均采用经尿道前列腺等离子切除术,根据临床尿路感染诊断标准将病人分为感染组及未感染组。比较两组病人术后炎症因子水平。使用多因素Logistic回归分析老年前列腺增生症术后尿路感染的危险因素。结果 186例病人术后发生尿路感染28例,发生率15.05%;感染组病人单核细胞趋化蛋白1(MCP1)、成纤维细胞生长因子2(FGF2)、成纤维细胞生长因子7(FGF7)、肿瘤坏死因子(TNF)-α及白细胞介素(IL)-6水平显著高于未感染组,差异有统计学意义(P<0.05);感染组及未感染组年龄、前列腺大小、术前预防性使用抗生素、术前因尿潴留行导尿术、手术时间、术后留置导尿管时间、住院总时间、糖尿病比较差异有统计学意义(P<0.05);二分类多因素Logistic回归分析显示,术前因尿潴留行导尿术、术后留置导尿时间≥7天、合并糖尿病均为影响老年前列腺增生术后症尿路感染的独立危险因素(OR=2.08、1.76、1.78,P<0.05)。结论术后尿路感染病人出现明显的细胞炎性反应,老年前列腺增生症病人术后尿路感染受多种因素共同影响,其中主要包括术前因尿潴留行导尿术、术后留置导管时间过长及合并糖尿病等。Objective To investigate the status of urinary tract infection and cellular inflammatory mechanism in elderly patients with prostate hyperplasia.Methods A total of 186 elderly patients with benign prostatic hyperplasia admitted to our hospital from October 2016 to October 2019 by transurethral plasma resection of prostate were selected as the research objects,and the patients were divided into the infected group and the uninfected group according to the diagnostic criteria of clinical urinary tract infection.Postoperative inflammatory factors were compared between the two groups.To compare the general information of the two groups,multivariate Logistic regression was used to analyze the risk factors of urinary tract infection after BPH in the elderly.Results Postoperative urinary tract infection occurred in 28 of 186 patients,with an incidence of 15.05%.The levels of monocyte chemokine 1(MCP1),fibroblast growth factor 2(FGF2),fibroblast growth factor 7(FGF7),tumor necrosis factor(TNF) and interleukin-6(IL-6) in the infected group were significantly higher than those in the non-infected group(P<0.05).Patients in the infected and uninfected groups were statistically significant in age,prostate size,preoperative preventive antibiotic use,urinary catheterization due to urinary retention,surgical time,postoperative indwelling catheter,total hospital stay,and diabetes(P<0.05).Two-category multivariate Logistic regression analysis showed that preoperative urinary catheterization due to urinary retention,postoperative indwelling catheterization time ≥7 days,and diabetes mellitus were all independent risk factors(OR = 2.08,1.76,1.78,P<0.05).Conclusion Patients with postoperative urinary tract infections have obvious cellular inflammatory reactions,postoperative urinary tract infections in elderly patients with benign prostatic hyperplasia are affected by a variety of factors,these include preoperative urethral catheterization due to urinary retention,prolonged indwelling catheter after operation,and diabetes.

关 键 词：老年 前列腺增生症 尿路感染 细胞炎性机制 

分 类 号：R699.8[医药卫生—泌尿科学] R691.3[医药卫生—外科学]