摘要
目的探讨留置不同材质输尿管支架导管引起的术后不同时期尿路感染率的差异。方法根据术后输尿管内留置支架导管的材质不同分为:A组,留置进口聚亚胺脂复合材料双J管;B组,留置国产复合高分子材料双J管;C组,留置普通输尿管直导管;D组,不留支架导管。每组55例患者(术前已行中段尿细菌培养证实无尿路感染),术后5d、2周、4周分别进行中段尿细菌培养和药敏试验。结果术后5d,A、B、C、D组尿路感染率分别为7.27%、7.27%、49.09%和5.45%,A、B、D组尿路感染率差异无显著性(χ2=0.89,P>0.1),A、B、D组与C组尿路感染率差异有高度显著性(χ2=51.92,P<0.005);术后2周,A、B组尿路感染率分别为9.80%和13.73%,差异无显著性(χ2=0.37,P>0.05);术后4周,A、B组尿路感染率分别为10.87%和27.27%,差异有显著性(χ2=7.95,P<0.05)。对主要病原菌敏感率高的抗菌药物:亚胺培南97.00%,万古霉素95.50%,阿米卡星89.55%,呋喃妥因83.58%,头孢哌酮82.09%,氧氟沙星77.61%。结论不同材质输尿管支架导管在术后留置的不同时期所引起的尿路感染率有差异,应根据病情及置管时间,选择合适材质的输尿管支架导管留置。
Objective To evaluate the differences in urinary tract infection （UTI） rates after patients receiving indwelling ureteral stents of different materials at different stages of post-operation. Methods Patients were divided into four groups according to different indwelling ureteral stents： Group A with imported polyamine-methylene resin compound material double-J tube; group B with domestic compound maeromolecular material double J catheter; group C with common straight catheter and group D without stent. There were 55 patients in each group, bacterial cultures and antimicrobial susceptibility tests of mid-portion urine from patients （without preoperative UTI identified by urine bacteria culture） were performed on the 5th day, 2 weeks and 4 weeks postoperatively respectively. Results On the 5th day of posvoperation, UTI rate in group A, B, C and D was 7. 27%, 7. 27%, 49. 09% and 5. 45% respectively, there were no significant difference in UTI rate among group A, B and D （X^2 = 0. 89, P〉 0. 1）, but the difference between group C and the other three groups were obvious （X^2 = 51.92, P〈0. 005） ; At the 2 weeks of posvoperation, UTI rate in group A and B was 9. 80% and 13. 73% respectively ,there was no obvious difference between the two （X^2 = 0. 37, P〉0. 05） ; at the 4 weeks of post-operation, UTI rate in group A and B was 10. 87% and 27. 27% respectively, there was obvious difference between the two （X^2 = 7. 95, P〈0. 05）. The main isolated bacteria were highly sensitive to the following antimicrobial agents： imipenem （97. 00%）, vancomyein （95.50%）, amikaein （89. 55%） , nitrofurantoin （83. 58%）, cefoperazone （82. 09%）, ofloxaein （77. 61%）. Conclusion There are differences in UTI in patients with indwelling ureteral stems of different materials at different stages of post-operation, proper ureteral stents should be chosen according to patients＇ disease condition and duration of catheterization.
出处
《中国感染控制杂志》
CAS
2008年第5期317-319,共3页
Chinese Journal of Infection Control
关键词
泌尿外科手术
输尿管
支架
尿路感染
细菌
因素
urinary tract operation ureter stents urinary tract infection bacteria
factor
