CAJ | 학술논문

目的分析前列腺穿刺活检术后相关并发症的情况及其相关危险因素. 方法回顾性分析2002年1月至2011年12月收治的1 959例接受经直肠前列腺穿刺活检患者的资料.根据预防性应用抗生素的种类将患者分为3组:A组应用喹诺酮类+甲硝唑,B组应用三代头孢+甲硝唑,C组应用三代头孢+β内酰胺酶类药物.A组1 067例,年龄(71.2±10.3)岁,前列腺体积(58.1±17.6) ml,糖尿病199例,全麻下穿刺582例,合并前列腺炎338例,前列腺癌431例;B组451例,年龄(72.4±11.9)岁,前列腺体积(52.3±19.9) ml,糖尿病86例,全麻下穿刺269例,合并前列腺炎147例,前列腺癌157例;C组441例,年龄(68.7±13.2)岁,前列腺体积(49.1± 15.1) ml,糖尿病82例,全麻下穿刺270例,合并前列腺炎148例,前列腺癌193例.统计术后1周内排尿、出血、感染等相关并发症的发生率,采用Logistic回归检验分析前列腺穿刺活检术后并发症的危险因素. 结果本组1 959例前列腺穿刺活检术后排尿和出血相关并发症的发生率分别约为80.0％和15.0％,发热的发生率为4.5％～ 13.5％.C组发热的发生率(0.9％)低于B组(5.1％)和A组(12.0％),差异均有统计学意义(P＜0.05).糖尿病患者发热的发生率(10.9％)高于无糖尿病者(7.2％),前列腺炎患者发热的发生率(10.1％)高于无前列腺炎者(6.9％),差异均有统计学意义(P＜0.05).Logistic回归检验结果显示糖尿病(OR=1.679)、前列腺炎(OR=1.495)、抗生素方案(OR=0.746)是前列腺穿刺活检术后发热的独立危险因素(P均＜0.05),而发热与前列腺体积、患者年龄、穿刺针数、麻醉方式以及病理结果无关(P均＞0.05). 结论前列腺穿刺活检术前控制糖尿病和前列腺炎,并根据本地区细菌耐药监测结果选择抗生素短期应用可降低术后感染的发生率.
목적 분석전렬선천자활검술후상관병발증적정황급기상관위험인소. 방법 회고성분석2002년1월지2011년12월수치적1 959례접수경직장전렬선천자활검환자적자료.근거예방성응용항생소적충류장환자분위3조:A조응용규낙동류+갑초서,B조응용삼대두포+갑초서,C조응용삼대두포+β내선알매류약물.A조1 067례,년령(71.2±10.3)세,전렬선체적(58.1±17.6) ml,당뇨병199례,전마하천자582례,합병전렬선염338례,전렬선암431례;B조451례,년령(72.4±11.9)세,전렬선체적(52.3±19.9) ml,당뇨병86례,전마하천자269례,합병전렬선염147례,전렬선암157례;C조441례,년령(68.7±13.2)세,전렬선체적(49.1± 15.1) ml,당뇨병82례,전마하천자270례,합병전렬선염148례,전렬선암193례.통계술후1주내배뇨、출혈、감염등상관병발증적발생솔,채용Logistic회귀검험분석전렬선천자활검술후병발증적위험인소. 결과 본조1 959례전렬선천자활검술후배뇨화출혈상관병발증적발생솔분별약위80.0％화15.0％,발열적발생솔위4.5％～ 13.5％.C조발열적발생솔(0.9％)저우B조(5.1％)화A조(12.0％),차이균유통계학의의(P＜0.05).당뇨병환자발열적발생솔(10.9％)고우무당뇨병자(7.2％),전렬선염환자발열적발생솔(10.1％)고우무전렬선염자(6.9％),차이균유통계학의의(P＜0.05).Logistic회귀검험결과현시당뇨병(OR=1.679)、전렬선염(OR=1.495)、항생소방안(OR=0.746)시전렬선천자활검술후발열적독립위험인소(P균＜0.05),이발열여전렬선체적、환자년령、천자침수、마취방식이급병리결과무관(P균＞0.05). 결론 전렬선천자활검술전공제당뇨병화전렬선염,병근거본지구세균내약감측결과선택항생소단기응용가강저술후감염적발생솔.
Objective To evaluate the prevalence of prostate biopsy complications and identify its risk factors.Methods Clinical data of 1959 patients underwent prostate biopsy between Jan.2002 and Dec.2011 were retrospectively analyzed.These patients were divided into three groups according to different prophylactic antibiotics (Group A:quinolone+metronidazole; Group B:third generation cephalosporin+metronidazole; Group C:third generation cephalosporin+ beta lactamases).Baseline data and complications within 1 week following prostate biopsy were collected.The Logistic regression analysis were used for data analysis.Results Between 2002 and 2011,the rates of voiding and bleeding related complications of prostate biopsy were 80％ and15％,but the fever rates were 4.5％-13.5％.After prostate biopsy,the fever rate of group C was lower compared with group B and A (0.9％ vs.5.1％ vs.12.0％,P＜0.05),the fever rate of diabetic was higher than that without diabetes (10.9％ vs.7.2％,P＜0.05),the fever rate of patient with prostatitis was higher than that without prostatitis (10.1％ vs.6.9％,P).The fever after prostate biopsy was associated with diabetes,prostatitis and different antibiotics (OR =1.679,1.495,0.746; all P＜0.05),but was not related to prostate size,age,biopsy cores,anesthesia and pathology results (P ＞ 0.05).Conclusions Preoperative management of diabetes mellitus and prostatitis,and short-term application of antibiotics according to local bacterial resistance surveillance results can decrease the incidence of fever after prostate biopsy.