输尿管留置双J管患者拔除双J管后不常规使用抗菌药物的临床疗效观察

Observation on clinical effect of non-use of antibiotics in patients with double J ureteral stent after removal of double J tube

目的观察输尿管留置双J管患者拔除双J管后不常规使用抗菌药物的临床疗效。方法选取167例输尿管留置双J管患者,随机分为观察组(85例)与对照组(82例)。观察组拔除双J管后不使用抗菌药物,对照组拔除双J管后使用抗菌药物。比较两组拔管后第2天尿频、尿急、尿痛、肉眼血尿、腰痛发生情况及尿常规、尿培养阳性结果。结果拔管后第2天,观察组尿频9例、尿急8例、尿痛4例、肉眼血尿5例、腰痛5例;对照组尿频7例、尿急7例、尿痛3例、肉眼血尿4例、腰痛4例。两组拔管后第2天尿频、尿急、尿痛、肉眼血尿、腰痛发生率比较,差异均无统计学意义(P>0.05)。拔管后第2天,观察组白细胞(WBC)≥3+/HP 9例、尿培养阳性4例;对照组WBC≥3+/HP 8例、尿培养阳性3例。两组拔管后第2天WBC≥3+/HP、尿培养阳性发生率比较,差异均无统计学意义(P>0.05)。结论对于留置输尿管双J管的患者,只要原发病治疗满意,每日最大尿量>2 L,拔管后不需要常规使用抗菌药物。

Objective To observe the clinical efficacy of non-use of antibiotics in patients with double J ureteral stent after removal of double J tube.Methods A total of 167 patients with double J ureteral stent were randomly divided into observation group(85 cases)and control group(82 cases).The observation group received no antibiotics after double J ureteral stent removal,and the control group received antibiotics after double J ureteral stent removal.The occurrence of frequent urination,urgency,dysuria,gross hematuria,low back pain on the 2nd day after extubation,as well as the positive results of urine routine and urine culture were compared between the two groups.Results On the 2nd day after extubation,the observation group had 9 cases of frequent urination,8 cases of urgency,4 cases of dysuria,5 cases of gross hematuria,5 cases of low back pain;the control group had 7 cases of frequent urination,7 cases of urgency,3 cases of dysuria,4 cases of gross hematuria,4 cases of low back pain.There was no statistically significant difference in incidence of frequent urination,urgency,dysuria,gross hematuria,low back pain on the 2nd day after extubation between the two groups(P>0.05).On the 2nd day after extubation,the observation group had 9 cases of white blood cells(WBC)≥3+/HP and 4 cases of positive urine culture;the control group had 8 cases of WBC≥3+/HP and 3 cases of positive urine culture.On the 2nd day after extubation,there was no statistically significant difference in incidence of WBC≥3+/HP and urine culture between the two groups(P>0.05).Conclusion For patients with dpositive results of urine routine and urine culture,as long as the primary disease treatment is satisfactory,the maximum daily urine output>2 L,and the routine use of antibacterial drugs is not required after extubation.