宫颈癌根治术后尿路感染危险因素及病原学  

Etiological characteristics and risk factors for postoperative urinary tract infection in radical hysterectomy patients

作　　者：何科[1] 袁林静 牛刚[1] 尧冰 瞿虎[2] HE Ke;YUAN Lin-jing;NIU Gang;YAO Bing;QU Hu(The First Affiliated Hospital of Sun Yat-Sen University,Guangzhou,Guangdong 510080,China;不详)

机构地区：[1]中山大学附属第一医院妇产科,广东广州510080 [2]中山大学附属第六医院泌尿外科,广东广州510655

出　　处：《中华医院感染学杂志》2023年第10期1555-1558,共4页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金(8170100302)。

摘　　要：目的探讨宫颈癌根治术后尿路感染危险因素及感染病原学特点,为临床制定预防措施提供理论依据。方法回顾性分析2020年3月-2022年3月中山大学附属第一医院妇产科收治的135例宫颈癌根治术患者的临床资料,将发生尿路感染的51例患者纳入感染组,未发生尿路感染的84例患者纳入未感染组。探究宫颈癌根治术后尿路感染病原学特点,单因素及多因素Logistic回归分析宫颈癌根治术后尿路感染危险因素。结果51例尿路感染患者中段尿标本共培养出81株病原菌,主要为革兰阴性菌(65.43%);感染组年龄>60岁、患高血压、糖尿病、插管次数>2次、术后尿潴留患者占比均高于未感染组(P<0.05),手术时间、住院时间、尿管留置时间均较未感染组延长(P<0.05);多因素Logistic回归分析结果显示,年龄>60岁、糖尿病、术后尿潴留、尿管留置及住院的时间均为宫颈癌根治术后尿路感染的独立危险因素(P<0.05)。结论宫颈癌根治术后尿路感染患者检出病原菌以革兰阴性菌为主,尿路感染的危险因素包括年龄>60岁、糖尿病、术后尿潴留、住院时间长、尿管留置时间长,临床可据此给予患者针对性的抗菌治疗及干预措施,以减少尿路感染的发生。OBJECTIVE To explore the etiological characteristics and risk factors for postoperative urinary tract infection in the radical hysterectomy patients so as to provide theoretical basis for clinical prevention.METHODS The clinical data were collected from 135 patients who underwent radical hysterectomy in obstetrics and gynecology department of the First Affiliated Hospital of Sun Yat-Sen University from Mar 2020 to Mar 2022 and were retrospectively analyzed.51 patients who had urinary tract infection were assigned as the infection group,and 84 patients who did not have urinary tract infection were assigned as the no infection group.The etiological characteristics of the postoperative urinary tract infection were explored.Univariate analysis and multivariate logistic regression analysis were performed for the risk factors for the postoperative urinary tract infection in the radical hysterectomy patients.RESULTS Totally 81 strains of pathogens were isolated from midstream urine specimens of the 51 patients with urinary tract infection,65.43%of which were gram-negative bacteria.The proportions of patients with more than 60 years of age,hypertension,diabetes mellitus,more than 2 times of intubation and postoperative urinary retention were higher in the infection group than in the no infection group(P<0.05);the operation duration,length of hospital stay and urinary catheter indwelling time were longer in the infection group than in the no infection group(P<0.05).The result of multivariate logistic regression analysis showed that more than 60 years of age,diabetes mellitus,postoperative urinary retention,urinary catheter indwelling and length of hospital stay were the independent risk factors for the postoperative urinary tract infection in the patients undergoing radical hysterectomy(P<0.05).CONCLUSION The gram-negative bacteria are dominant among the pathogens isolated form the radical hysterectomy patients with postoperative urinary tract infection.The more than 60 years of age,diabetes mellitus,postoperative urinary

关 键 词：宫颈癌 宫颈癌根治术 尿路感染 危险因素 干预措施 

分 类 号：R737.33[医药卫生—肿瘤]