经尿道前列腺切除术后聚维酮碘膀胱灌注预防尿路感染的研究

Clinical investigation of bladder irrigation of povidone-iodine in the prevention of urinary tract infections after transurethral resection of the prostate

目的探讨经尿道前列腺切除术后尿路感染的原因,并观察采用0.25%聚维酮碘膀胱灌注预防的效果,以期提高临床诊治水平。方法选取2010年2月-2014年1月106例经尿道前列腺切除术后感染患者为研究对象,分析术后感染的危险因素,将感染患者分成对照组和观察组,每组各53例,对照组采用生理盐水灌注,观察组采用0.25%聚维酮碘膀胱灌注治疗,观察治疗后相关指标变化。结果对照组患者术后第1天白细胞升高、拔管后尿培养阳性、拔管后尿白细胞≥10/HP发生率分别为50.94%、24.53%、22.64%,观察组分别为35.85%、18.87%、13.20%,两组比较差异有统计学意义(P<0.05);经logostic多因素分析显示,糖尿病、术前留置导尿、术前未应用抗菌药物是造成术后尿路感染的危险因素,差异有统计学意义(P<0.05),而与年龄、高血压病无关。结论聚维酮碘膀胱灌注能有效地预防治疗尿道前列腺切除术后尿路感染发生率,且安全性高。

OBJECTIVE To investigate the causes of urinary tract infections after transurethral resection of the prostate and to observe the effect of povidone‐iodine intravesical irrigation （0 .25% ） so as to improve the clinical diagnosis and treatments .METHODS From Feb .2010 to Jan .2014 ,a total of 106 cases of infected patients after transurethral resection of the prostate were chosen as study objects .The risk factors of postoperative infections were analyzed .All the patients were divided into control group and observation group with 53 cases each .The control group was irrigated with normal saline while the observation group adopted 0 .25% of povidone‐iodine for therapy .The changes of related indexes were observed .RESULTS The control group occurred leukocytosis , positive urine culture after extubation ,and the rate of urinary leukocytes ≥ 10/HP after extubation were 50 .94%,24 .53% ,and 22 .64% on the first day after the operation in the control group ,corresponding to the observation group were 35 .85% ,18 .87% and 13 .20% .The differences were significant （P〈0 .05） .Logistic multiple‐factor analysis showed that diabetes ,retention catheterization before operation and fail of using antibiotics preoperatively were the risk factors for urinary tract infections postoperatively .The differences were significant （P〈0 .05） .The age and hypertension were irrelevant to the infections .CONCLUSION Povidone‐iodine intravesical treatment can ef‐fectively prevent post‐prostatectomy urinary tract infection and is relatively safe .