良性前列腺增生术后尿路感染的发生情况及其危险因素分析  

Analysis of the occurrence and risk factors of urinary tract infection after operation of benign prostatic hyperplasia

作　　者：陈少川[1] 张源锋[1] CHEN Shaochuan;ZHANG Yuanfeng(Department of Urology,Shantou Central Hospital,Shantou 515031,China)

机构地区：[1]汕头市中心医院泌尿外科,广东汕头515031

出　　处：《沈阳医学院学报》2022年第5期497-500,共4页Journal of Shenyang Medical College

摘　　要：目的:分析良性前列腺增生术后尿路感染的发生情况及其危险因素。方法:回顾性分析2020年1月至12月我院收治的146例良性前列腺增生患者的临床资料,均接受经尿道前列腺电切术(TURP)治疗,根据术后是否发生尿路感染分为感染组(n=20)、非感染组(n=126),记录2组病原菌分布情况,采用多因素Logistic回归分析法分析前列腺增生术后发生尿路感染的危险因素。结果:20例术后发生尿路感染的患者尿液标本共培养出病原菌24株,其中革兰阴性菌17株(70.83%),以大肠埃希菌为主(37.50%);革兰阳性菌7株(29.17%),以屎肠球菌为主(16.67%)。经多因素Logistic回归分析结果显示,年龄≥60岁、伴糖尿病、术前留置导尿、手术时间≥60 min、未预防性使用抗菌药物、医师经验为初学者为前列腺增生术后尿路感染的独立危险因素(OR分别为2.620、7.257、3.019、2.328、1.309、2.328;95%CI分别为1.217~5.637、1.396~37.726、1.479~6.162、1.118~4.485、1.063~1.611、1.118~4.485,P<0.05)。结论:前列腺增生术后尿路感染病原菌主要为革兰阴性菌,且尿路感染发生与年龄、糖尿病、术前是否留置导尿、手术时间、是否预防性使用抗菌药物、医师经验等密切相关,临床可予以针对性干预措施以降低术后尿路感染发生率,进而改善患者预后。Objective:To analyze the occurrence and risk factors of urinary tract infection after operation of benign prostatic hyperplasia.Methods:The clinical data of 146 patients with benign prostatic hyperplasia admitted to our hospital from Jan2020 to Dec 2020 were retrospectively analyzed,and all of them were treated by transurethral resection of the prostate(TURP).According to the occurrence of urinary tract infection after operation,the patients were divided into infection group(n=20)and non-infection group(n=126).The distribution of pathogenic bacteria in the two groups was recorded.Multivariate logistic regression analysis was used to analyze the risk factors of urinary tract infection.Results:A total of 24 strains of pathogenic bacteria were cultured in the urine specimens of 20 patients with postoperative urinary tract infection,of which 17strains(70.83%)were Gram-negative bacteria,mainly Escherichia coli(37.50%)and 7 strains(29.17%)were Gram-positive bacteria,mainly Enterococcus faecium(16.67%).The results of multivariate logistic regression analysis showed that age≥60years old,diabetes,preoperative catheterization,operation time≥60 min,no use of prophylactic antibiotics,and physician experience as a beginner were independent risk factors of urinary tract infection after operation of prostatic hyperplasia(OR=2.620,7.257,3.019,2.328,1.309,2.328,95%CI was 1.217-5.637,1.396-37.726,1.479-6.162,1.118-4.485,1.063-1.611,1.118-4.485,P<0.05).Conclusions:The pathogenic bacteria of urinary tract infection after operation of prostatic hyperplasia are mainly Gram-negative bacteria,and it is closely related to age,diabetes,preoperative catheterization,operation time,prophylactic use of antibiotics,and physician experience.Targeted intervention measures should be taken to reduce the incidence of postoperative urinary tract infection,thereby improving the prognosis of patients.

关 键 词：良性前列腺增生 尿路感染 经尿道前列腺电切术 危险因素 

分 类 号：R691.3[医药卫生—泌尿科学]