CAJ | 학술논문

目的：观察经尿道前列腺电切（TURP）术后不同时间脓尿、菌尿的发生率及变化规律，为临床抗菌治疗提供指导依据。方法：以本院2010年1月-2014年5月收治的76例前列腺增生症（BPH）患者为研究对象，患者均接受TUPR治疗。记录术后1周，1、2、3个月时的脓尿发生率与菌尿发生率，并对不同时间的发生率进行比较；术后3个月按照脓尿发生情况将病例分为脓尿组与正常组，对两组的前列腺切除体积进行比较。结果：术后1周，1、2、3个月时的脓尿发生率依次为47.4%（36/76）、100%（74/74）、60.3%（41/68）及33.8%（23/68）；不同时间菌尿的发生情况依次为：术后1周7.9%（6/76），其中大肠埃希菌3例，铜绿假单胞菌2例，粪肠球菌1例；术后1个月菌尿发生率为9.4%（7/74），其中粪肠球菌3例，大肠埃希菌2例，表皮葡萄球菌2例；术后2个月菌尿发生率为7.4%（5/68），其中大肠埃希菌3例，表皮葡萄球菌1例，口腔链球菌1例；术后3个月菌尿发生率为0。对不同时间的脓尿率及菌尿率进行比较，结果显示不同时间的菌尿发生率比较差异无统计学意义（P>0.05），脓尿率比较差异有统计学意义（P<0.05）。脓尿组的前列腺切除体积为（31.72±9.56）mL，正常组为（23.29±8.16）mL，组间比较差异具有统计学意义（P<0.05）。结论：TURP术后均会发生脓尿，且随着时间的延长其发生率逐渐下降，单纯脓尿者与手术创伤中所致炎症反应有关，具自愈性；单纯菌尿者为无症状菌尿或细菌定植，两者均无需使用抗菌药物治疗。
목적：관찰경뇨도전렬선전절（TURP）술후불동시간농뇨、균뇨적발생솔급변화규률，위림상항균치료제공지도의거。방법：이본원2010년1월-2014년5월수치적76례전렬선증생증（BPH）환자위연구대상，환자균접수TUPR치료。기록술후1주，1、2、3개월시적농뇨발생솔여균뇨발생솔，병대불동시간적발생솔진행비교；술후3개월안조농뇨발생정황장병례분위농뇨조여정상조，대량조적전렬선절제체적진행비교。결과：술후1주，1、2、3개월시적농뇨발생솔의차위47.4%（36/76）、100%（74/74）、60.3%（41/68）급33.8%（23/68）；불동시간균뇨적발생정황의차위：술후1주7.9%（6/76），기중대장애희균3례，동록가단포균2례，분장구균1례；술후1개월균뇨발생솔위9.4%（7/74），기중분장구균3례，대장애희균2례，표피포도구균2례；술후2개월균뇨발생솔위7.4%（5/68），기중대장애희균3례，표피포도구균1례，구강련구균1례；술후3개월균뇨발생솔위0。대불동시간적농뇨솔급균뇨솔진행비교，결과현시불동시간적균뇨발생솔비교차이무통계학의의（P>0.05），농뇨솔비교차이유통계학의의（P<0.05）。농뇨조적전렬선절제체적위（31.72±9.56）mL，정상조위（23.29±8.16）mL，조간비교차이구유통계학의의（P<0.05）。결론：TURP술후균회발생농뇨，차수착시간적연장기발생솔축점하강，단순농뇨자여수술창상중소치염증반응유관，구자유성；단순균뇨자위무증상균뇨혹세균정식，량자균무수사용항균약물치료。
Objective:To observe the incidence,variation and significance of pyuria and bacteriuria of different time periods after TURP and provide guidance for clinical antimicrobial therapy.Method:76 cases of BPH patients admitted to our hospital from January 2010 to May 2014 were selected for the study.Patients were treated with TUPR treatment.The incidences of pyuria and bacteriuria after 1 week,1 month,2 months and 3 months were recorded, and the incidences of different times were compared;the patients were divided into pyuria group and the normal group in accordance with the occurrence of pyuria after three months,and the prostatectomy volume of the two groups were compared.Result:The pyuria incidences after 1 week,1month,2 months and 3 months were sequentially 47.4%(36/76),100%(74/74),60.3%(41/68)and 33.8%(23/68);occurrence of bacteriuria of different times were as follows:after 1 week 7.9%(6/76),including 3 cases of E.coli,2 cases of pseudomonas aeruginosa,1 case of E.faecalis;after 1 month bacteriuria rate was 9.4%(7/74),with 3 cases of Enterococcus faecalis,2 cases of E.coli,2 cases of staphylococcus epidermidis;after 2 months bacteriuria rate was 7.4%(5/68),including 3 cases of E.coli,1 case of staphylococcus epidermidis,1 case of oral streptococci;after 3 months bacteriuria was 0.Pyuria and bacteriuria rates at different times were compared.Result:The incidence of bacteriuria at different times was no significant difference (P>0.05),pyuria rate had statistically significant difference(P<0.05).The prostate resection volume of pyuria group was(31.72±9.56)mL and that of the normal group was(23.29±8.16)mL,the differences between the two groups were statistically significant(P<0.05).Conclusion:After TURP,pyuria decreased over time.Simple pyuria is related to inflammatory reaction caused by surgical trauma and is self-healing;simple bacteriuria is asymptomatic bacteriuria or bacterial colonization.The use of antibiotic therapy is not needed in both cases.