预防性抗生素在经直肠前列腺穿刺活检术中的应用

目的 评价和探讨抗生素防治前列腺穿刺活检术后感染的有效方法。方法 对192例前列腺疾病患者行经直肠超声引导13点前列腺系统穿刺活检术。所有患者随机分为3组。A组62例,口服安慰剂（维生素C）;B组64例,口服单剂量环丙沙星0．5g加甲硝唑0．4g/d;C组66例,分2次口服环丙沙星1.0g加甲硝唑0.8g/d,共3d;所有患者均在活检后48h进行尿培养,发热者再进行血培养。结果 3组患者感染性并发症（尿路感染和发热）的发生率为A组11％（7／62）,B组3％（2／64）,C组3％（2／66）,C组3％（2／66）。感染性并发症的发生率在A组明显高于B组（χ^2=7.16)和C组（χ^2=7.34),差异具有显著性意义（P＜0．01）。而B、C两组间感染性并发症的发生率相当（χ^2=0.23),差异无显著性意义（P＞0．05）。结论 应用恰当的单剂量抗生素预防经直肠前列腺穿刺活检术后的感染是有效的。

Clinical significance of antibiotic prophylaxis for transrectal prostate biopsy

Objective To evaluate the efficacy and safty of single-dose oral antibiotic prophylaxis in the prevention of postprocedure infections in patients undergoing transrectal prostate biopsy. Methods Between September 1998 and March 2001, a total of 192 patients who had an abnormal digital rectal examination and/or prostate specific antigen 4ng/ml or greater underwent transrectal ultrasound guided systematic 13 cores prostate biopsy. The patients were randomly divided into three groups. Group A (62) received a placebo(Vit C) tablet twice a day for 3 days, group B (64) a single dose of ciprofloxacin (0.5 g) and metronidazole (0.4 g), and group C (66) the same combination twice a day for 3 days. Urine cultures were obtained 48 h after the biopsy and blood cultures when patients who developed fever. Results Noninfective complications included were rectal bleeding, haematuria and pain. Infective complications included urinary tract infection and fever. There was no significant difference among the three groups in noninfective complications but the incidence of infective complications in group A was significantly higher than in groups B and C(P<0.01). There was no significant difference among group B and C in infective complications (P>0.05). Conclusions Our study shows single-dose oral antibiotic prophylaxis is effective and safe to prevent infectious complications follow transrectal prostate biopsy.