上尿路感染性结石清石术后长期间断口服磷霉素氨丁三醇散的疗效对照研究  

Comparative study on the clinical efficacy of intermittent oral administrationof fosfomycin trometamol for a long time after removalof upper urinary infection stones

作　　者：刘慧倩 王宁[1] 姚俊杰 刘振宇 尹志康[1] LIU Huiqian;WANG Ning;YAO Junjie;LIU Zhenyu;YIN Zhikang(Department of Urology,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China)

机构地区：[1]重庆医科大学附属第一医院泌尿外科,重庆400016

出　　处：《重庆医学》2024年第5期717-722,共6页Chongqing medicine

摘　　要：目的探讨长期间断口服磷霉素氨丁三醇散(FMT)在上尿路感染性结石清石术后控制尿路感染、降低结石复发率中的有效性及安全性。方法纳入符合标准的患者共171例,根据随机数字表法分为FMT组(使用FMT)、头孢组(使用头孢克肟)及空白组(未使用抗生素)各57例。最终纳入统计分析的FMT组55例、头孢组47例及空白组48例,并于结石清石术后定期随访3组患者的尿路感染及结石复发情况。结果3组患者基线资料比较,差异均无统计学意义(P>0.05)。3组患者术后3、6个月的尿路感染复发率比较差异有统计学意义(P=0.010、P<0.001)。进一步成对比较结果显示,术后3个月,FMT组的尿路感染复发率低于空白组(P<0.05),但与头孢组比较差异无统计学意义(P>0.05);术后6个月,FMT组的尿路感染复发率低于头孢组及空白组(P<0.05)。3组患者术后1、3年的结石复发率比较差异均有统计学意义(P=0.028、0.015)。进一步成对比较结果显示,术后1年,FMT组结石复发率低于头孢组及空白组(P<0.05);术后3年,FMT组结石复发率低于空白组(P<0.05),但与头孢组比较差异无统计学意义(P>0.05)。FMT组和头孢组的药物不良反应总发生率差异无统计学意义(P=0.131)。结论FMT在上尿路感染性结石清石术后控制尿路感染方面优于头孢克肟。Objective To investigate the clinical efficacy and safety of long-term intermittent oral administration of fosfomycin trometamol(FMT)in the control of urinary tract infection and the reduction of stone recurrence rate after removal of upper urinary infection stones.Methods A total of 171 patients who met the inclusion criteria were enrolled and divided into the FMT group(using FMT),cephalosporin group(using cefixime),and blank group(not using antibiotics)according to the random number method,with 57 cases in each group.Finally,55 cases in the FMT group,47 cases in the cephalosporin group and 48 cases in the blank group were included in the statistical analysis,and the urinary tract infection and stone recurrence of the three groups were followed up regularly after the stone removal operation.Results There was no statistical significance in the baseline data of the three groups(P>0.05).There were significant differences in the recurrence rate of urinary tract infection at the 3rd and 6th month among the 3 groups(P=0.010,P<0.001).Further pair-wise comparison showed that the recurrence rate of urinary tract infection at the 3rd month in the FMT group was lower than that in the blank group(P<0.05),but there was no statistical difference compared with the cephalosporin group(P>0.05).The recurrence rate of urinary tract infection at the 6th month in the FMT group was lower than that in the cephalosporin group and blank group(P<0.05).The recurrence rate of stones in the 1st and 3rd year of the three groups were statistically different(P=0.028,0.015).Further pair-wise comparison showed that the 1st year stone recurrence rate of the FMT group was lower than that of the cephalosporin group and blank group(P<0.05).The 3rd year stone recurrence rate of the FMT group was lower than that of the blank group(P<0.05),but there was no statistical difference compared with the cephalosporin group(P>0.05).There was no significant difference in the total incidence of adverse drug reaction between the FMT group and cephalosporin group(

关 键 词：磷霉素氨丁三醇散 感染性结石 随机对照研究 临床疗效 

分 类 号：R692.4[医药卫生—泌尿科学]