定向抗菌预防法在防治经直肠前列腺穿刺活检术后感染的应用评价

Antimicrobial prophylaxis in prevention oriented application value after infection rectum prostate biopsy

目的探讨针对经直肠行前列腺穿刺活检手术患者实施定向抗菌预防,对防治感染的临床效果及应用价值,为临床资料提供参考依据。方法选取2007年5月-2013年4月实施经直肠B超引导前列腺穿刺活检手术患者360例,随机分为3组,每组各120例;稀聚维酮碘灌肠组患者术前常规实施稀聚维酮碘灌肠;环丙沙星组患者术前在稀聚维酮碘灌肠基础上根据医师经验使用环丙沙星预防感染;定向抗菌组患者术前在稀聚维酮碘灌肠基础上根据肛拭子培养结果使用抗菌药物预防感染,对比3组患者感染情况,采用SPSS 13.0进行统计分析。结果稀聚维酮碘灌肠组患者发生感染26例感染率21.67%,环丙沙星组患者发生感染11例感染率9.17%,定向抗菌组无一例患者感染,明显优于其他两组;定向抗菌组肛拭子培养共分离出82株次病原菌,其中大肠埃希菌最多占69.51%。结论针对经直肠行前列腺穿刺活检手术患者实施定向抗菌预防方法防治感染临床效果显著确切,减少了临床并发症的发生,降低了抗菌药物的使用剂量,值得临床推广应用。

OBJECTIVE To investigate the treatment of antimicrobial prophylaxis in prevention oriented application for transrectal prostate biopsy surgical antimicrobial prophylaxis for patients with targeted clinical effect on the prevention of infection and value, so as to provide the basis for clinic. METHODS In May 2007 to Apr. 2013 period, the department implemented B ultrasound-guided transrectal prostate biopsy surgery 360 cases were randomly divided into three groups, dilute povidone-iodine enema group of 120 patients, preoperative routine implemented only dilute povidone-iodine enema; ciprofloxaein group of 120 patients, preoperative in dilute povidone-iodine enema based on the basis of physician experience with ciprofloxaein to prevent infections; directed antibacterial group 120 patients, preoperative in dilute povidone-iodine enema anal swab culture on the basis of the results based on the use of antibiotics to prevent infection, comparing three groups of patients infection situation. SPSS13.0 software was used for statistical analysis. RESULTS Dilute povidoneiodine enema group patients experienced a total 26 cases of infections, accounting for 21. 67%, ciprofloxaein group of patients with 11 cases of infections, accounting for 9.17%, and the directed antibacterial group with no infection, which was significantly better than other patient groups. A total of 82 strains of pathogenic bacteria were isolated in directed antibacterial group with anal swab, among which Escherichia coli was the most, accounting for 69. 51%. CONCLUSION The targeted antibiotic to prevent infection prevention is significant to the patients with infection after rectum prostate biopsy, reducing the incidence of clinical complications and the use of antibiotics dosage, which is worthy of clinical application.