物理抗菌材料防治输尿管支架管留置相关感染的临床研究

The clinical research about physical antibacterial material in prevention and treatment of ureteral stent related urinary tract infections

目的 通过置入被覆物理抗菌膜的输尿管支架管,观察物理抗菌材料在防治输尿管支架管留置引起感染的作用.方法 120例患者随机分为实验组和对照组,实验组予输尿管镜碎石术后置入物理抗菌材料输尿管支架管,对照组置入未予特殊处理的同公司同批次输尿管支架管,比较两组患者术后导管留置相关感染的差异性.结果 术后3、7、14、28 d试验组的尿路感染发生率分别为3.3％、6.7％、6.7％、16.7％.术后3、7、14、28 d对照组的尿路感染发生率分别为6.7％、20.0％、30.0％、43.3％.术后3d实验组和对照组尿路感染的发生率差异无统计学意义（P＞0.05）,而术后7、14、28 d尿路感染发生率实验组比对照组明显降低（P＜0.05）.实验组中C反应蛋白（CRP）、降钙素原（PCT）、尿白细胞计数等实验室检查指标在术后3d与对照组差异无统计学意义（P＞0.05）,术后7、14、28 d实验组CRP、PCT及尿中白细胞计数均比对照组降低（P＜0.05）.结论 置入经过被覆物理抗菌材料处理的输尿管支架管能够有效地避免及减轻导管留置相关感染的发生率.

Objective Through inserting the ureteral stent covered with physical antimicrobial film,to investigate the roles of physical antibacterial material in preventing and treating infection caused by indwelling ureteral stent.Methods 120 cases were randomly divided into two groups：observation group and control group.The ureteral stent covered with physical antimicrobial film was placed into the ureter after ureteroscopy lithotripsy in observation group.And in control group,the ureteral stent not covered with physical antimicrobial film was inserted into the ureter after ureteroscopy lithotripsy.The ureteral stents were from the same company and had the same assignment.The infection related to the ureteral stent indwelling was compared between two groups after operation.Results Patients in the observation group,3,7,14,28 days after the operations the incidence of urinary tract infection were 3.3%,6.7%,6.7% and 6.7% respectively.In control group,the incidence of urinary tract infection were 6.7%,20.0%,30.0% and 43.3%respectively after the operations 3,7,14 and 28 days.The urinary tract infection rate at 3rd day post-operations in the observation group and control group had no significant difference.At 7th,14th,and 28th day post-operation,the urinary tract infection rate in the observation group was lower than in the control group obviously （P 〈 0.05）.There was no significant difference in C-reactive protein （CRP）,procalcitonin （PCT） and urine white blood cells count in the observation group and control group 3 days post-operations （P 〉 0.05）.At 7th,14th,and 28th day post-operation,the CRP,PCT and urine white blood cell count were reduced in the observation group as compared with those in the control group （P 〈 0.05）.Conclusion The clinical studies confirmed that the ureteral stent covered with physical antimicrobial film can effectively avoid and reduce the infection related to ureteral stent indwelling.