摘要
目的探讨上尿路结石与细菌感染的相互关系。方法对530例上尿路结石患者术前作中段尿细菌培养,术中取肾盂尿和结石消毒前后及结石处棉拭子作细菌培养。结果530例结石中感染石120例(22.6%),女性高于男性。感染石菌种主要为表皮葡萄球菌和大肠杆菌,分别占60.1%和32.5%。结石直径≥1.0cm、表面粗糙、质松及阴性结石的感染石发生比例高于结石直径<1.0cm、表面光滑、质硬,以及阳性结石,差异有统计学意义(P值均<0.01);输尿管上段感染石高于其它部位,差异有统计学意义(P值均<0.01)。结石处棉拭子细菌培养阳性仅见于感染石患者,且菌种与结石菌种相同。感染石与非感染石患者的中段尿、肾盂尿细菌培养阳性比例分别为24.2%、39.2%vs6.3%、3.2%,临床泌尿系感染发生比例分别为15.8%和1.2%,P值均<0.01。结论细菌可作为上尿路结石成核成分之一,菌种以表皮葡萄球菌和大肠杆菌为主。感染石发生比例与结石性状有关,感染石易导致泌尿系感染。
Objective To investigate the correlation between bacteria and upper urinary tract calculi （ UUTC）. Methods 530 cases of UUTC were enrolled in the study. Mid-stream urine culture was obtained before operation. Intraoperative pelvic urine culture,cotton swab culture of stone-incarcerated mucosal surface, pre- and post-sterilized stone culture were also carried out. Results Among 530 cases of UUTC, the stone culture showed positive （infectious stone） in 120 cases （22.6%） ,more prevalent in females than in males. Staphylococcus epidermidis and Escherichia coil were the predominant bacteria, accounting for 60.1% and 32.5% ,respectively. The infection rate with which a stone size was ≥ 1.0 cm with coarse surface ,loose density or radiolucent was much higher than that of size 〈 1.0 cm with smooth surface,hard or radiopaque （ P 〈 0.01 ）. Infection rate of upper ureteral stone was higher than that in other sites. Only in patients with infectious stones, the cotton swab culture showed positive and with the same strain. The infection rates of mid-stream and pelvic urine in patients with infectious stones were significantly higher than those with non-infectious stones （24.2% vs 6.3% and 39.2% vs 3, 2% ,respectively）. Clinically the incidence of urinary tract infection （UTI） was 15.8% for patients with infectious stones and 1.2% for those with noninfectious stones. Conclusions Bacteria, mainly staphylococcus epidermidis and Escherichia coil, may constitute one of the stone nuclear elements. Stone size, density, surface characteristics and radiolucency arerelated to bacterial susceptibility. Stone-incarcerated urothelia are susceptible to bacterial infection from stone perse. Infectious stones are responsible for clinical and latent UTI with close relation to the severity of hydronephrosis.
出处
《中华泌尿外科杂志》
CAS
CSCD
北大核心
2005年第8期542-544,共3页
Chinese Journal of Urology
