子宫颈癌患者术后尿路感染相关问题分析  

Analysis of Related Problems of Postoperative Urinary Tract Infection in Patients With Cervical Cancer

作　　者：庄丽娟[1] 李素玉[1] 衣欢 ZHUANG Lijuan;LI Suyu;YI Huan(Gynecology Department,Fujian Maternity and Child Health Hospital,Fuzhou Fujian 350001,China)

机构地区：[1]福建省妇幼保健院妇科,福建福州350001

出　　处：《中国卫生标准管理》2021年第24期123-127,共5页China Health Standard Management

摘　　要：目的探讨子宫颈癌根治术后患者发生尿路感染的危险因素、病原学分布及药敏特征。方法回顾性分析2015年1月—2019年12月因子宫颈癌于本院行广泛性全子宫切除+盆腔淋巴结清扫术241例患者的临床资料,统计术后发生尿路感染(urinary tract infection,UTI)的情况,分析其危险因素、病原学分布及药敏特征。结果241例患者中共有62例患者术后出现UTI,单因素分析提示,开腹手术、留置尿管时间≥20 d、导尿次数≥2次及术后尿潴留与术后发生UTI相关;Logistic回归分析提示,术后尿潴留及留置尿管时间≥20 d是导致术后UTI的独立危险因素。对病原学分布进行分析发现,UTI患者尿液培养细菌谱以革兰阴性菌为主,其中占比最高的为大肠埃希菌,其次为鲍曼不动杆菌;对其药敏特征分析发现,革兰阴性菌对碳青霉烯类、氨基糖苷类及头孢三代具有较高的敏感性,而对广谱青霉素则呈现较高的耐药性。根据药敏结果对其针对性抗感染治疗后患者尿潴留情况明显改善,差异有统计学意义(P<0.05)。结论术后尿潴留及留置尿管时间≥20 d是子宫颈癌根治术后患者发生UTI的独立危险因素,而发生UTI患者的病原学分布以革兰阴性菌为主,临床上应根据药敏结果尽早针对性用药以减少患者住院时间及住院费用,同时改善其术后生活质量。Objective To investigate the risk factors,etiological distribution and drug sensitivity of urinary tract infection in patients with cervical cancer after resection.Methods A retrospective analysis of the clinical data of 241 patients who underwent extensive hysterectomy+pelvic lymph node dissection for cervical cancer in our hospital from January 2015 to December 2019,and counted the occurrence of urinary tract infection(urinary tract infection,UTI),analyzed its risk factors,pathogenic distribution and drug sensitivity characteristics.Results A total of 62 out of 241 patients had UTI after surgery.Univariate analysis suggested that open surgery,indwelling catheter time≥20 days,catheterization frequency≥2 times,and postoperative urinary retention were associated with postoperative UTI.Logistic regression analysis suggested that postoperative urinary retention and catheter indwelling time≥20 days were independent risk factors for postoperative UTI.Analysis of the pathogenic distribution found that the bacterial spectrum of UTI patients’urine culture was mainly Gram-negative bacteria,with Escherichia coli of the highest proportion,followed by Acinetobacter baumannii;analysis of its drug sensitivity characteristics found that,Gram-negative bacteria were highly sensitive to carbapenems,aminoglycosides,and cephalosporin third generation,while they were highly resistant to broad-spectrum penicillins.According to the results of drug susceptibility,urinary retention of patients after targeted anti-infection treatment was significantly improved,and the difference was statistically significant(P<0.05).Conclusion Postoperative urinary retention and catheter indwelling time≥20 days are independent risk factors for UTI in patients undergoing radical cervical cancer surgery,and the pathogenic distribution of UTI patients is mainly Gram-negative bacteria.Clinically,it should be based on drug susceptibility.Results Targeted medication as soon as possible to reduce the patients’hospitalization time and hospitalization

关 键 词：子宫颈癌 尿潴留 尿路感染 危险因素 病原学分布 药敏特征 

分 类 号：R713[医药卫生—妇产科学]