定向抗菌药物应用预防前列腺切除术后尿路感染的临床研究

Clinical effect of directed antibiotics application on prevention of urinary tract infections after prostatectomy

目的探讨定向抗菌药物应用预防前列腺切除术患者尿路感染的临床效果,降低前列腺切除术后尿路感染的发生率,提高前列腺切除术的治疗水平。方法选取2012年4月-2013年4月行前列腺切除术的患者120例,采用数字随机表法将其随机分为对照组和观察组,每组60例;对照组患者围术期按照抗菌药物临床应用规范实施常规抗感染措施,观察组患者术前5d实施肛拭子检测,并根据检测结果选择相应的抗菌药物进行定向抗菌预防术后尿路感染,比较两组患者术后感染症状、尿细菌定量培养及术后尿路感染率。结果术后尿路感染率对照组20.0%、观察组1.67%,对照组尿路感染率明显高于对照组,组间比较差异均有统计学意义(P<0.05);两组患者手术后12h内发热率观察组为1.67%、对照组为16.67%,48h后两组患者中段尿细菌定量培养检测,观察组低于对照组,差异均有统计学意义(P<0.05)。结论对实施前列腺切除手术的患者采取定向抗菌药物应用预防术后尿路感染,可显著降低患者术后尿路感染率。

OBJECTIVE To explore the clinical effect of directed antibiotic application on prevention of urinary tract infections in patients undergoing prostatectomy so as to reduce the incidence of the postoperative urinary tract in‐fections and improve the level of treatment with prostatectomy .METHODS A total of 120 patients who underwent the prostatectomy from Apr 2012 to Apr 2013 were enrolled in the study and randomly divided into the control group and the observation group ,with 60 cases in each .The control group was treated with standard conventional prevention measures according to the clinical use of antibiotics during the perioperative period ,while the observa‐tion group was given the directed antibiotic prophylaxis based on the results of anal swab test which was conducted 5 days before the surgery ;the postoperative infection symptoms ,quantitative urine culture ,and incidence of post‐operative urinary tract infections were observed and compared between the two groups of patients .RESULTS The incidence of postoperative urinary tract infections was 20 .0% in the control group , significantly higher than 1 .67% in the observation group （P〈0 .05） .The incidence of fever was 1 .67% in the observation group within 12 hours after the surgery ,16 .67% in the control group .The quantitative bacterial culture of midstream urine of the observation group was signifiant lower than that of the control group after the treatment for 48 hours （P〈0 .05） . CONCLUSION The directed antibiotics application can contribute to the significant reduction of the incidence of postoperative urinary tract infections in the patients undergoing the prostatectomy .