甲醛消毒穿刺针预防经直肠前列腺穿刺术后感染的作用

Efficacy of Formalin Disinfection of the Biopsy Needle between Cores in Preventing Post-Biospy Infectious Complications

目的探讨甲醛消毒穿刺针预防经直肠前列腺穿刺活检术后感染的作用及可能导致感染并发症的危险因素。方法收集超声引导下经直肠前列腺穿刺活检术的(TRUS-PB)患者621例,根据操作过程中穿刺针的消毒方式,分为对照组(n=150)、甲醛组(n=225)及碘伏组(n=246)。收集各项临床资料,观察终点事件为穿刺术后感染,采用Logistic回归分析穿刺后感染发生的危险因素。结果出现穿刺后感染45例(7.2%),对照组、甲醛组及碘伏组分别为25例(55.6%)、5例(11.1%)、15例(33.3%)。使用甲醛或碘伏消毒均可降低穿刺后感染并发症的发生率,且甲醛组与对照组差别有统计学意义(P<0.01)。Logistic回归分析显示,甲醛消毒穿刺针与穿刺后感染呈负相关(OR=0.077,95%CI:0.026~0.227,P<0.01),提示其可以预防发生感染。而体质量指数(BMI)超过25 kg/m 2(OR=3.636,95%CI:1.704~7.752,P=0.001)、糖尿病(OR=3.106,95%CI:1.391~6.897,P=0.006)、术前泌尿道感染(OR=5.952,95%CI:2.809~12.658,P<0.01)、术前留置尿管(OR=2.381,95%CI:7.87~71.429,P<0.01)是穿刺感染的独立预测因素。结论甲醛消毒穿刺针可以显著降低经直肠前列腺穿刺术后感染的发生率。BMI>25 kg/m 2、糖尿病、术前泌尿系感染、术前留置尿管是穿刺后感染发生的独立预测因素。

Objective To evaluate the efficacy of formalin disinfection of biopsy needle between cores in preventing post transrectal prostate biopsy infection and to assess potential risk.Methods Clinical data of 621 transrectal ultrasound-guided prostate biopsy in the First Affiliated Hospital of Fujian Medical University from January 2015 to May 2020 were retrospectively analyzed.According to the sterilization method of the biopsy needle during operation,the cases were divided into control group(n=150),formalin group(n=225)and iodophor group(n=246).We collected clinical data and recorded post-biopsy infection.Logistic regression analysis was used to analyze the risk factors of post-biopsy infectious complication.Results Among the 621 patients who underwent transrectal prostate biopsy under ultrasound guidance,45(7.2%)had post-biopsy infections,and 25(55.6%),5(11.1%),15(33.3%)in the control,formalin,and iodophor groups,respectively.The use of formalin or iodophor disinfection can reduce the incidence of infectious complications after puncture,but only the difference shown in formalin group was statistically significant(P<0.01).Logistic regression analysis showed that the formalin-sterilized biopsy needle was negatively correlated with infection after biopsy(OR=0.077,95%CI:0.026-0.227,P<0.01),suggesting that it could prevent the occurrence of infection.While BMI>25 kg/m 2(OR=3.636,95%CI:1.704-7.752,P=0.001),diabetes(OR=3.106,95%CI:1.391-6.897,P=0.006),preoperative urinary tract infection(OR=5.952,95%CI:2.809-12.658,P<0.01),and preoperative indwelling urinary catheter(OR=2.381,95%CI:7.87-71.429,P<0.01)were independent predictor of biopsy infection.Conclusion Formalin-sterilized biopsy needles can significantly reduce the incidence of infection after transrectal prostate biopsy.BMI>25 kg/m 2,diabetes mellitus,preoperative urinary tract infection,and preoperative indwelling urinary catheter are independent predictors of post-biopsy infectious complications.