复发性尿路感染的分期治疗

目的：设计一种药物分期治疗法,以临床治愈为目标,观察其对复发性尿路感染的疗效。方法：采用的药物分期治疗方法为：①治疗期抗生素按常规剂量治疗,直至尿常规正常。待尿常规正常后,再维持治疗4周;②巩固期抗生素减量应用,维持尿常规正常4周;③维持期抗生素减为每晚1次,维持治疗3个月,如尿常规正常则停药;④观察期停用抗生素观察半年。各期尿检查如有反复,则转为前一期治疗。抗生素应用方法为选择几种有效抗生素,在治疗期和巩固期,每种抗生素治疗1周,轮换应用。维持期每种抗生素应用1～2周。结果：68例尿路感染治愈60例（88.2%）,有效6例（8.8%）,无效2例（2.94%）。治愈的60例患者总疗程22～118周,平均50.1±20.65周。治疗期6～75周,平均30.48±15.23周。巩固期4～13周,平均5.28±2.34周。维持期12～30周,平均14.33±3.70周。有38例符合难治性尿路感染,与30例普通型相比,其治疗期、巩固期和总疗程均延长（P〈0.01）。治疗前后血常规、肝肾功能无明显变化。结论：对于复发性尿路感染,采用治疗期、巩固期和维持期的分期治疗,并轮换应用多种抗生素的方法治愈率高,未见血常规、肝肾功能等不良反应。

The Method of Stage Treatment of Recurrent Urinary Tract Infection

Objective：The aim of study was to design a method of stage treatment, and to investigate its efficacy on recurrent urinary tract infection. Methods：The method of stage treatment includes four periods as follows： （1）Treatment period： The regular dose of antibiotics was maintained until the urine routine test result became normal. Then the antibiotics should still be prescribed for four weeks. （2） Consolidation period; The dosage of antibiotics was reduced to maintain the urine routine test nor mal for 4 weeks. （3） Maintenance period： The dosage of antibiotics was reduced to quaque nocte（once every night） and the treatment should be kept for three months. If result of the urine routine test kept normal, the medicine should be stopped. （4） Observation period： We observed the patients for six months after withdrawal of antibiotics. During the treatment if the result of urine test became abnormal repeatedly, the patient should return to the previous treatment period. Several effective medicines were chosen. During the treatment and consolidation period, each medicine should be prescribed for one week alternatively. And during the maintenance period, each should be used for one or two weeks. Results： Among 68 patients, 60 cases were cured, 6 cases were effective, and two cases were the opposite. The total treatment time was from 22 weeks to 118 weeks in the cured group, including treatment period（6 to 75 weeks） ,consolidation period（4 to 13 weeks） ,and maintenance period（12 to 30 weeks）. The average period of each four stages was 50. 1± 20.6 weeks, 30.48± 15.23 weeks,5.28± 2.34 weeks, 14.33 ± 3.7 weeks. There are 38 cases in the refractory urinary tract infections group, and the period of consolidation, treatment and the total treatment were longer（ P〈0. 01 ）than the ordinary-type treatment group. There were no significant changes in blood routine, liver and renal functions among, before and after the treatment. Conclusion：For recurrent urinary tract infection,