良性前列腺增生患者经尿道前列腺电切术后并发尿路感染的相关因素分析

目的分析良性前列腺增生(BPH)患者经尿道前列腺电切术(TURP)后并发尿路感染的相关因素,以引起临床重视。方法收集芜湖市第一人民医院泌尿外科2009年12月至2013年1月收治的接受TURP的BPH患者570例,对影响TURP术后尿路感染的相关因素进行分析。结果 570例BPH患者TURP术后发生尿路感染者86例,尿路感染发生率为15.1%。年龄>65岁、术者年资较低、术前有尿潴留而行导尿术,BPH合并糖尿病、术前未预防性使用抗生素、手术时间>1 h及术后留置导管时间>6 d是导致术后尿路感染的具有统计学意义的单因素;BPH患者合并糖尿病(OR 2.71,95%CI 1.26³.58)、术前因尿潴留行导尿术(OR 3.30,95%CI 2.923.58)、术前因尿潴留行导尿术(OR 3.30,95%CI 2.92¹1.54)、留置导管时间>6 d(OR 2.96,95%CI 1.3811.54)、留置导管时间>6 d(OR 2.96,95%CI 1.38¹0.52)是TURP术后发生尿路感染的危险因素;而术前预防性使用抗生素(OR 1.82,95%CI 1.0510.52)是TURP术后发生尿路感染的危险因素;而术前预防性使用抗生素(OR 1.82,95%CI 1.05¹9.78)是保护因素。结论术前合并糖尿病、尿潴留、留置导管时间>6 d是导致TURP术后尿路感染的危险因素,应合理控制患者血糖,预防性应用抗生素,缩短导管留置时间,尽早拔除导尿管以降低TURP术后尿路感染的发生。

Analysis of Related Factors for Urinary Tract Infections in Patients with Benign Prostatic Hyperplasia after Transurethral Resection of the Prostate

Objective To analyze the related factors for urinary tract infections in patients with benignprostatie hyperplasia（BPH） after transurethral resection of the prostate to cause clinical attention. Methods Clinical information of 570 cases of BPH were collected in Department of Urinary Surgery of Wuhu First People＇s Hospital from Dec. 2009 to Jan. 2013. The relevant factors of urinary tract infection after TURP were analyzed. Results There were 86 cases of urinary tract infection in 570 patients with BPH after TURP, and the urinary tract infection rate was 15.1%. The factors of age 〉 65 years,low seniority of the surgeon, preoperative catheterization due to urinary retention, BPH combined diabetes, preoperative prophylactic antibiotics, surgical time 〉 1 h and postoperative indwelling catheter 〉 6 d were statistically significant single factor leading to postoperative urinary tract infection. BPH patients with diabetes mellitus（ OR 2.71,95% CI 1.26-3.58 ） ,urinary retention preoperatively line catheterization（ OR 3.30, 95 % CI 2.92-11.54 ） , indwelling catheter time 〉 6 d （ OR 2.96,95 % CI 1.38-10.52 ） were risk factors for urinary tract infection after TURP. The preoperative prophylactic antibiotics（ OR 1.82,95% C[ 1.05- 19.78 ） was a protective factor. Conclusion Preoperative diabetes, urinary retention, prolonged indwelling catheter after TURP are risk factors causing urinary tract infection, reasonable control of blood glucose, prophylactic antibiotics, shortening catheter time, removal of the catheter as soon as possible should be done in order to reduce the incidence of urinary tract infection after TURP.