金银花水煎液尿道冲洗对导尿管表面细菌生物膜形成的影响

effect of intraurethral irrigation with honeysuckle water-decoction on formation of bacterial biofilm on the surface of catheter

目的 观察用金银花水煎液对导尿管表面细菌生物膜形成的影响.方法 选择80例需留置导尿的男性患者,所有患者导尿前均无泌尿系统感染症状且尿培养阴性.将患者随机分为四组:金银花水煎液尿道冲洗组(a组)、25%聚维酮碘(pvp)尿道冲洗组(b组)、生理盐水尿道冲洗组(c组)和未进行尿道冲洗组(d组),每组20例.四组患者均在7 d后拔除导尿管,通过扫描电镜观察导尿管表面细菌生物膜形成情况,并测量其厚度.结果电镜观察可见导尿管表面有不均匀的基质物覆盖,细菌成片状、团块状或成堆分布.a、b、c、d四组生物膜平均厚度分别为(17.876±11.788)μm、(31.090±15.006)μm、(33.716±11.927)μm和(67.762±23.588)μm.经秩和检验,a、b、c三组导尿管表面生物膜厚度与d组比较差异有统计学意义(p<0.01),a组与b组、c组比较差异有统计学意义(p<0.01),而b、c两组间差异无统计学意义(p>0.01).结论 使用金银花水煎液尿道冲洗能有效预防导尿管表面细菌生物膜的形成. abstract： objective to investigate the effect of intraurethral irrigation with honeysuckle water-decoction on formation of bacterial biofilm on the surface of the catheter. methods eighty male patients,who had no history of catheterization and no urinary infection with negative results of urine bacterial culture,were enrolled in the study. all patients were randomly divided into 4 groups with 20 cases in each: group a (patients underwent intraurethral irrigation with honeysuckle water-decoction); group b (intraurethral irrigation with 25% pvp); group c (intraurethral irrigation with normal saline ) and group d (no intraurethral irrigation). the urethral catheters were removed at the 7th day and the bacterial biofilm on the surface of the catheter was examined by scanning electron microscopy (sem). results sem demonstrated uneven- distributed matrixes coated on the surface of the catheter, and bacteria adhered to the matrixes. the average thickness of biofilm in group a, b, c and d was (17.876 ±11.788)μn, (31.090±15. 006)μm,(33.716±11.927)μm, (67.762±23.588)μm, respectively. the average thickness of biofilm in group a, b, c was significantly thinner than that in group d (p<0.01), and the thickness in group a was thinner than that in group b and c (p<0.01), but there was no significance difference between group b and group c (p>0.01). conclusions intraurethral irrigation with honeysuckle water-decoction can effectively reduce the formation of bacterial biofilm on the surface of the catheter.