中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2015年
42期
3458-3460
,共3页
黄钟明%李汉忠%纪志刚%肖河
黃鐘明%李漢忠%紀誌剛%肖河
황종명%리한충%기지강%초하
男性%尿流动力学%泌尿系感染
男性%尿流動力學%泌尿繫感染
남성%뇨류동역학%비뇨계감염
Male%Urodynamics%Urinary tract infections
目的 探讨男性患者行有创尿流动力检查后泌尿系感染的发生情况及易患因素.方法 对2010年1月至2013年12月在北京协和医院拟行尿流动力学检查的671例男性患者于检查前2～4周行清洁中段尿(或导管尿)细菌培养及尿常规检查,检查未见细菌生长[＜ 105细菌总数单位(cfu)/ml],同时尿常规白细胞＜15个/μl、硝酸盐在正常范围的患者准备接受检查,开始检查前再次行尿常规检测白细胞及硝酸盐无异常的患者接受有创尿流动力学检查,并于检查后48 ～ 72 h再次接受尿细菌培养,结合患者的年龄、病种、尿流动力学检查参数及诊断以及致病原种类分析男性患者有创尿流动力学检查后尿路感染的发生率和易感因素.结果 671例患者中49例检查前提示存在泌尿系感染,发生率为7.3％,其余622例尿培养及常规检查提示无感染的患者尿流动力学检查后有64例发生泌尿系感染,发生率10.3％,其中年龄≥65岁,合并有糖尿病以及存在膀胱出口梗阻(BOO)是导致感染的独立易感因素,最常见的致病菌为大肠埃希氏菌(53.1％,34/64)及粪肠球菌(17.2％,11/64).结论 男性患者行有创尿流动力检查后泌尿系感染发生率10％左右,针对年龄≥65岁,合并有糖尿病以及存在膀胱出口梗阻等患者,必要时可于检查前、后行预防性抗菌素治疗.
目的 探討男性患者行有創尿流動力檢查後泌尿繫感染的髮生情況及易患因素.方法 對2010年1月至2013年12月在北京協和醫院擬行尿流動力學檢查的671例男性患者于檢查前2～4週行清潔中段尿(或導管尿)細菌培養及尿常規檢查,檢查未見細菌生長[＜ 105細菌總數單位(cfu)/ml],同時尿常規白細胞＜15箇/μl、硝痠鹽在正常範圍的患者準備接受檢查,開始檢查前再次行尿常規檢測白細胞及硝痠鹽無異常的患者接受有創尿流動力學檢查,併于檢查後48 ～ 72 h再次接受尿細菌培養,結閤患者的年齡、病種、尿流動力學檢查參數及診斷以及緻病原種類分析男性患者有創尿流動力學檢查後尿路感染的髮生率和易感因素.結果 671例患者中49例檢查前提示存在泌尿繫感染,髮生率為7.3％,其餘622例尿培養及常規檢查提示無感染的患者尿流動力學檢查後有64例髮生泌尿繫感染,髮生率10.3％,其中年齡≥65歲,閤併有糖尿病以及存在膀胱齣口梗阻(BOO)是導緻感染的獨立易感因素,最常見的緻病菌為大腸埃希氏菌(53.1％,34/64)及糞腸毬菌(17.2％,11/64).結論 男性患者行有創尿流動力檢查後泌尿繫感染髮生率10％左右,針對年齡≥65歲,閤併有糖尿病以及存在膀胱齣口梗阻等患者,必要時可于檢查前、後行預防性抗菌素治療.
목적 탐토남성환자행유창뇨류동력검사후비뇨계감염적발생정황급역환인소.방법 대2010년1월지2013년12월재북경협화의원의행뇨류동역학검사적671례남성환자우검사전2～4주행청길중단뇨(혹도관뇨)세균배양급뇨상규검사,검사미견세균생장[＜ 105세균총수단위(cfu)/ml],동시뇨상규백세포＜15개/μl、초산염재정상범위적환자준비접수검사,개시검사전재차행뇨상규검측백세포급초산염무이상적환자접수유창뇨류동역학검사,병우검사후48 ～ 72 h재차접수뇨세균배양,결합환자적년령、병충、뇨류동역학검사삼수급진단이급치병원충류분석남성환자유창뇨류동역학검사후뇨로감염적발생솔화역감인소.결과 671례환자중49례검사전제시존재비뇨계감염,발생솔위7.3％,기여622례뇨배양급상규검사제시무감염적환자뇨류동역학검사후유64례발생비뇨계감염,발생솔10.3％,기중년령≥65세,합병유당뇨병이급존재방광출구경조(BOO)시도치감염적독립역감인소,최상견적치병균위대장애희씨균(53.1％,34/64)급분장구균(17.2％,11/64).결론 남성환자행유창뇨류동력검사후비뇨계감염발생솔10％좌우,침대년령≥65세,합병유당뇨병이급존재방광출구경조등환자,필요시가우검사전、후행예방성항균소치료.
Objective To assess the prevalence of male urinary tract infection (UTI) after invasive urodynamic studies and to determinate the risk factors by evaluating the clinical characteristics and urodynamic parameters of patients.Methods Six hundred and seventy-one consecutive men were recruited.All patients accepted urine routine tests and(or) urine culture three times.The first culture and routine tests were carried out in the 2 to 4 weeks before urodynamic studies by using clean-catch midstream urine (MSU) or catheter urine specimen.The second urine routine test was carried out at the start of examinations and the last urine culture were carried out in 48-72 hours after the investigations.Male patients with negative results (leucocytes ＜ 15 cells/ul and ＜ 105 colony-forming units per milliliter [cfu/ml]) in 1 st and 2nd time received a standard urodynamic investigation.The investigations of the remaining patients were postponed until the urinary tract infection had been treated.Results The prevalence of urinary tract infection before urodynamic investigation (with positive results in 1st and 2nd urine test) was 7.3％,and the prevalence after the investigation in patients without UTI before examination was 10.3％.Bladder outlet obstruction(BOO),age≥65 years,and diabetes were the risk factors for UTI after urodynamic investigation.The most common uropathogens in the urinary tract infections after the urodynamic investigation were Escherichia coli (53.1％,34/64) and Enterococcus faecalis (17.2％,11/64).Conclusion Despite a stringent standard operation protocol,the prevalence of UTI in male patients caused by urodynamic examination is about 10％.For the high-risk patients with BOO,older age,and diabetes,prophylactic antibiotic treatment before or after procedure may be necessary.
