中华泌尿外科杂志
中華泌尿外科雜誌
중화비뇨외과잡지
CHINESE JOURNAL OF UROLOGY
2014年
5期
359-362
,共4页
良性前列腺增生%经尿道前列腺电切术%脓尿%菌尿
良性前列腺增生%經尿道前列腺電切術%膿尿%菌尿
량성전렬선증생%경뇨도전렬선전절술%농뇨%균뇨
Benign prostatic hyperplasia%Transurethral resection of the prostate%Pyuria%Bacteriuria
目的 探讨经尿道前列腺电切(TU RP)术后不同时间脓尿、菌尿的发生率和变化规律及意义,为指导抗菌药物应用提供依据. 方法 2011年3月至2012年5月收治84例前列腺增生患者,年龄61 ～ 87岁,平均(71.9±7.6)岁.前列腺体积27.8～118.0 ml,平均(70.8±24.1) ml.均行TURP治疗,术后1周拔除导尿管时行导尿管培养及次日晨(24h后)尿常规、尿培养,并在术后第1、2、3个月时随访患者的尿常规、尿培养.诊断标准:尿常规检查白细胞＞5个/HP为脓尿,尿培养细菌计数≥1×104 CFU/ml为菌尿,导管培养细菌计数≥1× 104 CFU/ml为细菌培养阳性.脓尿合并菌尿者定义为尿路感染,予抗菌药物治疗后出组. 结果 术后1周、1个月、2个月、3个月的脓尿率分别为54.8％ (46/84)、100.0％ (82/82)、65.8％(48/73)、34.2％(25/73),差异有统计学意义(P＜0.05).术后3个月有脓尿组前列腺切除体积为(31.4±15.2) ml,无脓尿组为(24.8± 11.6) ml,两组比较差异有统计学意义(P＜0.05).术后1周、1个月、2个月、3个月的菌尿率分别为7.1％(6/84)、11.0％(9/82)、6.8％(5/73)、0,差异无统计学意义(P＞0.05). 结论 TURP术后患者均会出现脓尿,且随时间延长发生率逐渐降低,单纯脓尿而无菌尿者为炎症性反应,单纯菌尿而无脓尿者为无症状菌尿或细菌定植,均无需抗菌药物治疗.
目的 探討經尿道前列腺電切(TU RP)術後不同時間膿尿、菌尿的髮生率和變化規律及意義,為指導抗菌藥物應用提供依據. 方法 2011年3月至2012年5月收治84例前列腺增生患者,年齡61 ～ 87歲,平均(71.9±7.6)歲.前列腺體積27.8～118.0 ml,平均(70.8±24.1) ml.均行TURP治療,術後1週拔除導尿管時行導尿管培養及次日晨(24h後)尿常規、尿培養,併在術後第1、2、3箇月時隨訪患者的尿常規、尿培養.診斷標準:尿常規檢查白細胞＞5箇/HP為膿尿,尿培養細菌計數≥1×104 CFU/ml為菌尿,導管培養細菌計數≥1× 104 CFU/ml為細菌培養暘性.膿尿閤併菌尿者定義為尿路感染,予抗菌藥物治療後齣組. 結果 術後1週、1箇月、2箇月、3箇月的膿尿率分彆為54.8％ (46/84)、100.0％ (82/82)、65.8％(48/73)、34.2％(25/73),差異有統計學意義(P＜0.05).術後3箇月有膿尿組前列腺切除體積為(31.4±15.2) ml,無膿尿組為(24.8± 11.6) ml,兩組比較差異有統計學意義(P＜0.05).術後1週、1箇月、2箇月、3箇月的菌尿率分彆為7.1％(6/84)、11.0％(9/82)、6.8％(5/73)、0,差異無統計學意義(P＞0.05). 結論 TURP術後患者均會齣現膿尿,且隨時間延長髮生率逐漸降低,單純膿尿而無菌尿者為炎癥性反應,單純菌尿而無膿尿者為無癥狀菌尿或細菌定植,均無需抗菌藥物治療.
목적 탐토경뇨도전렬선전절(TU RP)술후불동시간농뇨、균뇨적발생솔화변화규률급의의,위지도항균약물응용제공의거. 방법 2011년3월지2012년5월수치84례전렬선증생환자,년령61 ～ 87세,평균(71.9±7.6)세.전렬선체적27.8～118.0 ml,평균(70.8±24.1) ml.균행TURP치료,술후1주발제도뇨관시행도뇨관배양급차일신(24h후)뇨상규、뇨배양,병재술후제1、2、3개월시수방환자적뇨상규、뇨배양.진단표준:뇨상규검사백세포＞5개/HP위농뇨,뇨배양세균계수≥1×104 CFU/ml위균뇨,도관배양세균계수≥1× 104 CFU/ml위세균배양양성.농뇨합병균뇨자정의위뇨로감염,여항균약물치료후출조. 결과 술후1주、1개월、2개월、3개월적농뇨솔분별위54.8％ (46/84)、100.0％ (82/82)、65.8％(48/73)、34.2％(25/73),차이유통계학의의(P＜0.05).술후3개월유농뇨조전렬선절제체적위(31.4±15.2) ml,무농뇨조위(24.8± 11.6) ml,량조비교차이유통계학의의(P＜0.05).술후1주、1개월、2개월、3개월적균뇨솔분별위7.1％(6/84)、11.0％(9/82)、6.8％(5/73)、0,차이무통계학의의(P＞0.05). 결론 TURP술후환자균회출현농뇨,차수시간연장발생솔축점강저,단순농뇨이무균뇨자위염증성반응,단순균뇨이무농뇨자위무증상균뇨혹세균정식,균무수항균약물치료.
Objective To observe the incidence and transformation of pyuria and bacteriuria in different time point after TURP and supply the evidence for antibiotic application.Methods From March,2011 to May,2012,84 patients with BPH admitted in our hospital.Their ages ranged from 61 to 87 years old,mean (71.9±7.6) years.The volume of prostate in those patients ranged from 27.8 to 118 ml,mean (70.8±24.1) ml.The procedure of TURP was undergone in all of them.In one week after the operation,two urine specimens from each patient,one for urine routine examination and one for urine culture,were collected 24 h after the catheter have been withdrawn.The catheter was also cultured.During the following-up,urine routine examination and urine culture were regularly performed in 1,2,3 months after surgery.If the patient had both pyuria and bacteriuria,he should be excluded the study.Results The pyuria rate on one week,one month,two months and three months were 54.8％ (46/84),100.0％ (82/82),65.8％ (48/ 73),34.2％ (25/73),respectively.There is a significance difference among those groups (P＜0.05).It seemed that the pyuria would appear in all patients.However,the incidence would gradually decrease.It seemed that the pyuria has the tendency of self-recovery.A significant difference of prostatic resection volume after 3 months could be observed in the pyuria group (31.4±15.2 ml) and non-pyuria group (24.8±11.6 ml) (P＜0.05).The bacteriuria rate on one week,1,2,3 months were 7.1％ (6/84),11.0％ (9/82),6.8％ (5/73)and 0,respectively.There is no significance difference among the groups (P＞0.05).Conclusions Pyuria will appear after TURP and the incidence reduced gradually following the time.The pyuria alone without the bacteriuria may be explained by inflammation,that antibiotics were unnecessary.The bacteriuria alone without the pyuria may be considered as asymptomatic bacteriuria or bacterial colonization,antibiotics were unnecessary,either.
