改良持续膀胱冲洗装置预防前列腺等离子电切术后尿路感染的效果

Effect of modified continuous bladder irrigation device on prevention of urinary tract infection in patients after operation of plasmakinetic resection of prostate

目的探讨改良持续膀胱冲洗装置预防前列腺等离子电切术（PKRP）术后尿路感染的效果。方法选取2011年1—12月行PKRP术后使用传统装置的126例患者作为对照组，2012年1-12月行PKRP术后使用改良装置的135例患者作为观察组。观察膀胱冲洗时间、拔尿管时间、尿管堵塞、漏尿、膀胱痉挛以及尿路感染等情况，比较两种冲洗装置用于持续膀胱冲洗对预防PKRP术后尿路感染的效果。结果观察组患者发生膀胱痉挛15例，尿管堵塞11例，漏尿13例，尿路感染2例；对照组分别为膀胱痉挛68例，尿管堵塞43例，漏尿58例，尿路感染12例，两组比较差异有统计学意义（x。值分别为55．194，26．805，43．610，8．304；P〈0．01）。观察组膀胱冲洗时间、拔尿管时间分别为（22．91±10．181），（129．89±46．632）h，对照组分别为（35．63±8．663），（190．18±57．744）h，两组比较差异均有统计学意义（t值分别为-16．380，-11．511；P〈0．01）。结论PKRP术后采用改良持续膀胱冲洗装置进行持续膀胱冲洗，尿路感染的概率更小，该装置的使用能很好地预防医院感染的发生。

Objective To explore the intervention effect of the modified continuous bladder irrigation device on preventing urinary tract infection after operation of plasmakinetic resection of prostate （PKRP）. Methods A total of 261 patients from January 2011 to December 2012 were divided into two groups, 126 cases from January 2011 to December 2011 used traditional device as control group, while 135 cases from January 2012 to December 2012 used modified device as observation group. The time of bladder irrigation, the total of white blood cells and bacteria, the time of urethral catheterization, ureter blockage, leakage urine, bladder spasm and urinary tract infection and so on after operation of PKRP were observed. Results After the intervention, the number of bladder spasm（ 15 vs 68）, ureter blockage（ 11 vs 43）, leakage urine（ 13 vs 58）,and urinary tract infection（2 vs 12） in observation group was significantly less than that in control group（ X^2 = 55. 194,26. 805,43. 610,8. 304, respectively; P 〈 0. 01 ）. And the time of bladder irrigation and urethral catheterization in observation group respectively was （22.91 ± 10. 181 ） h, （ 129.89 ± 46. 632） h, and that in control group respectively was （ 35.63 ± 8. 663 ） h, （ 190.18 ± 57. 744 ） h, and the difference was statistically significant（ t = - 16. 380, - 11.511, respectively ;P 〈 0.01 ）. Conclusions The use of the modified continuous bladder irrigation device can reduce the chance of urinary tract infection, and prevent hospital infection, which is worth promoting widely.