前列腺增生患者前切术后尿路感染的危险因素分析

Risk factors for postoperative urinary tract infections in benign prostatic hyperplasia patients undergoing transurethral resection

目的探讨前列腺增生患者前列腺电切术后尿路感染的危险因素分析,为临床提供感染预防控制依据。方法选取医院泌尿科2011年5月-2015年10月医治320例前列腺增生患者的临床资料为研究对象,以问卷方式对其术后尿路感染情况进行调查,并对患者年龄、病程、前列腺大小等可能影响因素进行分析,以logistic多因素分析法对影响术后尿路感染的危险因素进行分析。结果 48例患者发生尿路感染,感染率15%;病原菌检出革兰阴性菌占总检出的68%,革兰阳性菌占26%,真菌占6%;术前行导尿术、导尿管留置时间、前列腺大小、合并糖尿病等,术后感染相关因素比较差异均有统计学差异(P<0.05);多因素分析显示,导尿管留置时间、术前行导尿术及合并糖尿病为危险因素,预防抗菌药应用为保护性因素,比较差异有统计学意义(P<0.05)。结论合并糖尿病、术前行导尿术、导尿管留置时间及有无预防抗菌药应用是前列腺增生患者行经尿道电切术后并发尿路感染的危险因素,预防抗菌药应用为保护因素。

OBJECTIVE To explore the risk factors for postoperative urinary tract infections in benign prostatic hyperplasia patients undergoing transurethral resection so as to provide guidance for clinical prevention and control of the infections.METHODS The clinical data were collected from 320 patients with benign prostatic hyperplasia who were treated in the urology department of the hospital from May 2011 to Oct 2015,then the incidence of postoperative urinary tract infections was investigated through questionnaire survey,the influencing factors,including age,disease course,and size of prostate,were observed,and the multivariate logistic analysis was performed for the risk factors for the postoperative urinary tract infections.RESULTS The urinary tract infections occurred in 48 patients,with the infection rate 15%.Among the pathogens isolated,the gram-negative bacteria accounted for68%,the gram-positive bacteria accounted for 26%,and the fungi accounted for 6%.There was significant difference in the related factors for the postoperative infections,including the preoperative catheterization,time of urinary catheter indwelling,size of prostate,and complication with diabetic mellitus（P〈0.05）.The multivariate analysis indicated the time of urinary catheter indwelling,preoperative catheterization,and complication with diabetic mellitus were the risk factors and that the antibiotic prophylaxis was the protective factor（P〈0.05）.CONCLUSIONThe risk factors for the postoperative urinary tract infections in the benign prostatic hyperplasia patients undergoing transurethral resection include the complication with diabetic mellitus,preoperative catheterization,time of urinary catheter indwelling,and antibiotic prophylaxis;the antibiotic prophylaxis is the protective factor.