前列腺增生切除术后尿路感染危险因素

Risk factors of urinary tract infection after resection of prostatic hyperplasia

目的探讨前列腺增生切除术后尿路感染的危险因素。方法回顾性分析2018年1月-2020年1月于福建医科大学附属第二医院泌尿外科行前列腺增生切除术的281例患者的临床资料,根据患者术后是否发生尿路感染分为感染组(n=52)和未感染组(n=229)。比较两组术后1 d的血清单核细胞趋化蛋白1(MCP1)、成纤维细胞生长因子2(FGF2)、白细胞介素-6(IL-6)水平,并分析影响前列腺增生切除术后发生尿路感染的危险因素。结果术后1 d,感染组血清MCP1、FGF2、IL-6水平均高于未感染组(P<0.05)。经多因素Logistic回归分析结果显示,年龄≥65岁、合并糖尿病、手术时间≥60 min、留置尿管时间≥5 d及血清MCP1、FGF2、IL-6水平偏高为前列腺增生切除术后发生尿路感染的独立危险因素(P<0.05)。结论血清MCP1、FGF2、IL-6在前列腺增生切除术后尿路感染患者中呈高表达,且前列腺增生切除术后发生尿路感染的危险因素与患者年龄、是否合并糖尿病、手术时间、留置尿管时间及血清MCP1、FGF2、IL-6水平密切相关,临床应当重视并采取相关措施预防并控制前列腺增生切除术后发生尿路感染。

OBJECTIVE To investigate the risk factors for urinary tract infection after prostatic hyperplasia resection. METHODS A retrospective analysis of the clinical data of 281 patients who underwent prostatic hyperplasia in the Department of Urology, the second affiliated hospital of Fujian medical university between Jan. 2018 and Jan. 2020, and the patients were divided into the infected group(n=52) and the uninfected group(n=229) according to whether urinary tract infection occurred after operation. The levels of serum monocyte chemoattractant protein 1(MCP1), fibroblast growth factor 2(FGF2) and interleukin-6(IL-6) in the two groups 1 d after operation were compared, and the risk factors affecting urinary tract infection after prostatic hyperplasia were analyzed. RESULTS One day after operation, the levels of serum MCP1, FGF2 and IL-6 in the infected group were significantly higher than those in the uninfected group(P<0.05). The results of multivariate Logistic regression analysis showed that age≥65 years old, diabetes mellitus, operation time≥60 min, indwelling catheter time≥5 d, and high expression levels of serum MCP1, FGF2 and IL-6 were independent risk factors for urinary tract infection after prostatic hyperplasia(P<0.05). CONCLUSION Serum MCP1, FGF2, and IL-6 levels were high in patients with urinary tract infection after prostatic hyperplasia, and the risk factors for urinary tract infection after prostatic hyperplasia resection were closely related to the patient’s age, diabetes mellitus, operation time, indwelling catheter time and serum levels of MCP1, FGF2 and IL-6. Attention should be paid in the clinic and relevant measures should be taken to prevent and control urinary tract infections after prostatic hyperplasia.