膀胱肿瘤灌注化疗患者尿路感染相关因素分析

Related factors for urinary tract infections in bladder cancer patients undergoing postoperative intravesical irrigation chemotherapy

目的探讨膀胱肿瘤术后行膀胱灌注化疗患者尿路感染的相关因素,为制定有针对性的预防对策提供参考依据。方法选择2012年7月-2013年10月泌尿外科收治的114例膀胱肿瘤术后行膀胱灌注化疗患者临床资料,调查分析患者性别、年龄、灌注次数、留置导尿管、合并症及细菌培养结果,数据采用SPSS 19.0软件进行统计分析。结果 114例膀胱灌注化疗患者发生尿路感染41例,感染率35.96%;尿路感染患者的送检标本中共分离出病原菌49株,其中革兰阴性菌35株占71.43%,革兰阳性菌12株占24.49%,真菌2株占4.08%;年龄≥70岁、膀胱灌注>7次、留置导尿管、合并糖尿病及前列腺增生是膀胱肿瘤术后行膀胱灌注化疗患者尿路感染的独立危险因素。结论膀胱肿瘤术后行膀胱灌注化疗的患者尿路感染率较高,导致尿路感染发生的危险因素较多,应采取有效的预防措施,减少尿路感染的发生。

OBJECTIVE To explore the related factors for urinary tract infections in bladder cancer patients undergoing postoperative intravesical irrigation chemotherapy so as to formulate targeted prevention countermeasures.METHODS The clinical data were collected from 114 bladder cancer patients who underwent the postoperative intravesical irrigation chemotherapy in the department of urology from Jul 2012 to Oct 2013.A survey was conducted for the gender,age,number of times of irrigation,urinary catheter indwelling,complications,and results of bacterial culture;the statistical analysis of data was performed with the use of SPSS 19.0software.RESULTS The urinary tract infections occurred in 41 of 114patients who underwent the intravesical irrigation chemotherapy,with the infection rate 35.96%.A total of 49 strains of pathogens were isolated from the submitted specimens of the patients with urinary tract infections,including 35（71.43%）strains of gram-negative bacteria,12（24.49%）strains of gram-positive bacteria,and 2（4.08%）strains of fungi.The independent risk factors for the urinary tract infections in the bladder cancer patients undergoing the postoperative intravesical irrigation chemotherapy included the no less than 70 years of age,more than 7times of intravesical irrigation,urinary catheter indwelling,complication of diabetic mellitus,and prostatic hyperplasia.CONCLUSION The incidence rate of urinary tract infections is high in the bladder cancer patients undergoing the postoperative intravesical irrigation chemotherapy.There are a variety of risk factors for the urinary tract infections.It is necessary to take effective prevention measures so as to reduce the incidence of urinary tract infections.