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尿道下裂术后尿道分泌物细菌学特点与防治 被引量:5

The Bacteriological Character of Urethral Secretion and the Preventive and Curative Measures of Hypospadia after Operation
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摘要 目的:探讨尿道下裂术后尿道支架管分泌物的细菌学特点,探讨其预防与治疗措施。方法:本组33例,手术方式为原位尿道板代尿道(Snodgrass)12例,带蒂包皮横行内板代尿道(Duckett)1 7例,Duplay+Duckett4例,均采用膀胱穿刺造瘘,尿道放置支架管,术后分别于24 h、72 h、5天留取尿道支架管分泌物做细菌培养,根据培养结果选择相应的治疗措施。院外随访3个月~1年。结果:术后24 h,20例细菌培养阳性,其中大肠埃希菌16例(80%),金黄色葡萄球菌3例,阴沟肠杆菌1例。术后72 h,6例细菌培养阳性,第5天有2例细菌培养阳性(新发阳性绿脓杆菌1例)。尿瘘4例,阴茎根部感染化脓1例,尿道狭窄5例。结论:尿道下裂术后感染的细菌主要是肠道菌,术后采用有针对性的治疗措施是提高术后成功率的有效措施。 Objective:To explore the bacteriological character of urethral secretion and preventive and curative measures in hypospadia after operation. Methods:There were 33 cases of this group ,all patients underwent surgical treatment with Snodgrass procedures 12 cases, and Duckett procedures 17 cases, and Duplay-Duckett 4 cases. And all patients underwent epicystostomy and were put supporting tube in their urethra. With general nursing before operation, we collected Urethral Secretion for germiculture after 24 h, 72 h and 5 d respectively, and different nursing interventions were used acorrding to bacterial culture. According to culture results, select the appropriate therapeutic measures. Outside the hospital were followed up 3 months to 1 year. Results: Among 33 cases of hypospadias, 20 cases were found gemiculture positive in 24 hours after operation , Escherichia coli 16 cases(80%), Staphylococcus aureus 3 cases, Enterobacter cloacae 1 cases. On the other hand, there were 6 gemiculture positive cases after 72 hours, and only one case Staphylococcus aureus and one case Pseudomonas aeruginosa positive bacterial culture after operation 5th day. Among all patients, there were 4 cases complicating urinary fistula, 5 cases urethrostenosis,and one infection at the root of the penis. Conclusions:The bacterial infection of hypospadia after operation mainly caused by intestinal bacteria. Nichetargeting treatment and nursing may improve operation success rate of hypospadia.
出处 《临床泌尿外科杂志》 北大核心 2010年第4期288-290,共3页 Journal of Clinical Urology
关键词 尿道下裂 并发症 细菌学 hypospadia complication bacteriology
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