良性前列腺增生患者尿流动力学检查前预防性应用抗生素的研究

Preventive administration of antibiotics to patients with benign prostatic hyperplasia before urodynamic examination

目的:探讨良性前列腺增生(BPH)患者行尿流动力学检查前预防性应用抗生素的有效性及安全性。方法:选取2010年10月至2012年10月行尿流动力学检查的BPH患者256例,随机分为两组,对照组(n=118)检查前不用预防性抗生素应用,试验组(n=138)检查前30 min用头孢西丁钠1.0 g静滴后由同一名医生行全套尿流动力学检查。对比两组患者尿路感染发生率。结果:对照组患者中发生尿路感染24例(20.3%),试验组10例(7.3%),两组结果有统计学意义(P<0.01)。合并糖尿病患者感染率试验组6.7%(3/45),对照组23.5%(8/34),两组对比有统计学意义(P<0.05);合并残余尿(>50 ml)患者感染率试验组5.4%(3/56),对照组18.5%(10/54),两组对比有统计学意义(P<0.05);合并糖尿病及残余尿患者感染率试验组9.5%(2/21),对照组44.4%(8/18),两组对比有统计学意义(P<0.05);试验组中仅有3例出现药物不良反应(2.2%)。结论:BPH患者,特别是合并糖尿病及残余尿患者,行尿流动力学检查前预防性应用抗生素能有效预防尿路感染的发生,且具有良好的安全性。

[ Abstract ] Objective ： To discuss the effect and safety of preventive administration of antibiotics to patients with benign prosta- tic hyperplasia （BPH） before urodynamic examination. Methods： A total of 256 BPH patients to undergo urodynamic examination were randomly divided into a control group （n = 118 ） and a trial group （n = 138 ）. The former received no pre-treatment while the lat- ter were given cefoxitin sodium iv at 1.0 g 30 minutes before complete urodynamic examination. Then we compared the incidence rates of urinary tract infection between the two groups. Results ： Statistically significant differences were found in the incidence rate of uri- nary tract infection between the control and trial groups （20.3 % [ 24/1181 vs 7.3% [ 10/138 ], P 〈 0. 01 ）, as well as in those with diabetes mellitus （6.7% [3/451 vs 23.5% [8/34], P 〈0.05）, those with residual urine 〉50 ml （5.4% [3/56] vs 18.5% 110/54 ], P 〈 0.05 ）, and those with both diabetes mellitus and residual urine （ 9.5 % [ 2/21 ] vs 44.4 % [ 8/18 ], P 〈 0.05 ）. Only 3 patients （ 2.2% ） in the trial group had mild adverse drug reactions. Conclusion ： For BPH patients, particularly those with diabe- tes mellitus and residual urine, preventive administration of antibiotics before urodynamic examination is safe and can effectively protect the patients against urinary tract infection. Natl J Androl, 2013, 19 （11） ： 996-998