经尿道前列腺电切术前无菌尿的患者行预防性抗菌的合理性评价

目的研究无菌尿的老年患者,经尿道前列腺电切术(TURP)时接受预防性抗菌方案的疗效。方法120例TURP术前无菌尿的良性前列腺增生老年患者随机分为两组,抗生素组(60例)根据临床经验行静脉抗菌方案预防感染(4 d),对照组(60例)则输注5%葡萄糖盐溶液。比较两组TURP术后感染相关性指标。结果抗生素组在术后第4天的菌尿检出率低于对照组(P<0.05),但两组术后第28天的菌尿率及其他感染相关性并发症比较差异无统计学意义。患者TURP术后第4天菌尿与术后长期菌尿、菌血症或尿路感染、前列腺菌群检出率关系不密切。结论抗生素可以预防无菌尿老年患者TURP术后早期出现菌尿,但不能改善感染性并发症的发生率。经验性用药对不同来源分离的病菌不十分敏感。

Analysis on antibiotic prophylaxis in transurethral prostate resection of old patients with sterile urine

Objective To study the efficacy of antibiotic prophylaxis in old patients with negative urine cultures,who were submitted to transurethral prostate resection(TURP).Methods One hundred and twenty old benign prostatic hyperplasia(BPH) patients with sterile urine were divided into two groups(60 patients in each group) randomly.Antibiotic group received empirical venous antibiotics 4 days postoperative.Control group received 5% glucose saline as placebo.Their postoperative infection-associated parameters were compared.Results There were no significant differences between two groups in bacteriuria and infection-associated complications at the 28th day postoperatively.The ratio of bacteriuria in antibiotic group decreased significantly at postoperative at the 4th day when compared with that of control group.The bacteriuria at postoperative at the 4th day had no specific correlation with the long-term bacteriuria,the clinical observation of bacteremia and urinal tract infection,or the culture of prostatic tissue chip.Conclusions Antibiotic prophylaxis reduces the early postoperative bacteriuria for old patients with sterile urine before TURP,but its effectiveness for postoperative infectious complications is debatable.The antibiotics according to empirical validity are not specifically sensitive to the bacteria from various sources.