腹腔镜子宫肌瘤剜除术后泌尿系感染的危险因素及病原菌分布研究  

Risk factors and pathogen distribution of urinary tract infection after laparoscopic myomectomy

作　　者：李飞燕 Li Feiyan(The People's Hospital of Jishui County,Jishui,Jiangxi 331600)

机构地区：[1]吉水县人民医院,江西吉水331600

出　　处：《基层医学论坛》2023年第19期7-9,12,共4页The Medical Forum

摘　　要：目的探讨腹腔镜下子宫肌瘤剜除手术术后发生泌尿系感染的危险因素以及相关病原菌分布情况,为并发症的防治提供依据。方法分析62例择期行腹腔镜子宫肌瘤剜除手术患者的临床资料,统计术后泌尿系感染发生情况,分析感染发生相关危险因素,并进行病原菌分布测定及耐药试验。结果62例患者术后发生泌尿系统感染15例,感染发生率为24.19%,共计检出42株病原菌,药敏革兰阴性菌30株(71.43%),革兰阳性菌7株(16.67%),真菌5株(11.90%)。多因素Logistic回归分析结果显示,年龄、合并糖尿病、手术时间与住院天数是患者术后泌尿系感染发生的独立危险因素;耐药性分析结果显示,主要革兰阴性菌对头孢西丁、头孢哌酮、头孢吡肟耐药性高,主要革兰阳性菌对庆大霉素、苯唑西林、头孢唑林、环丙沙星、红霉素耐药性高。结论针对临床中接受腹腔镜子宫肌瘤剜除术治疗的患者,在术后需警惕泌尿系统感染,依据危险因素及病原菌具体分布,采取合理防治手段及抗生素药物干预,使患者术后早日恢复。Objective To investigate the risk factors of postoperative urinary tract infection and the distribution of related pathogens in patients undergoing laparoscopic myomectomy,so as to provide a favorable basis for the prevention and treatment of complications.Methods s Were retrospectively analyzed line analysis of 62 patients undergoing elective laparoscopic uterine fibroids gouge out related data in addition to surgery,postoperative urinary tract infections in patients with statistics,and the baseline data statistics and related risk factors for infection happened analysis,in addition to determine the distribution of pathogens and drug resistance test.Results There were 15 cases of urinary system infection in 62 patients after operation,and the infection rate was 24.19%.A total of 42 strains of pathogenic bacteria were detected,including 30 strains of Gram-negative bacteria(71.43%).7 strains of Gram-positive bacteria(16.67%);5 strains of fungi(11.90%);Univariate and multivariate Logistic regression analysis showed that age,diabetes mellitus,operation time and length of stay were independent risk factors for postoperative urinary tract infection.The results of drug resistance analysis showed that the main gram-negative bacteria had high resistance to cefoxitin,cefoperazone and cefepime,while the main gram-negative bacteria had high resistance to gentamicin,benzacillin,cefazolin,ciprofloxacin and erythromycin.Conclusion According to the clinical condition accepted laparoscopic uterine fibroids in addition to surgery patients,need to be mindful urinary tract infections after surgery,based on types and risk factors on pathogen,resistance analysis,further intervention,and adopt reasonable prevention and control means and reasonable antibiotic drugs to patients with postoperative recover at an early date.

关 键 词：腹腔镜子宫肌瘤剜除术 泌尿系感染 危险因素 病原菌分布 耐药 

分 类 号：R713.1[医药卫生—妇产科学]