摘要
目的探讨在手术中应用含有庆大霉素的冲洗液以预防输尿管镜碎石术后感染的临床效果。方法采用前瞻性、随机对照研究。2003年7月-2006年6月116例具有输尿管镜碎石术后感染高危因素患者被随机分为庆大霉素组（GP）和对照组（CP），GP组在术中使用含有庆大霉素的冲洗液。术后随访2周，期间出现临床感染征象者考虑为术后感染。结果116例患者最终有109例完成手术，其中GP组58例，CP组51例。在所有完成手术患者中，13例临床诊断为术后感染（占11．90／00），其中GP组3例（3／58，5．2％），CP组10例（10／51，19．6％），两者间差异有统计学意义（Y。=5．3342，P=0．0209）。13例诊断为术后感染的患者中有8例分离到病原菌，1例为血培养阳性；其中革兰阳性菌2例（占15．4％），革兰阴性菌5例（占38．5％），1例为白念珠菌（占7．7％），另5例细菌培养阴性（占38．5％）。结论输尿管镜碎石术后感染仍以革兰阴性菌较为常见，在采取适当保护措施后发生血流感染概率较低。术中使用的冲洗液中加入庆大霉素后，可以减少术后感染的发生。
Objective To evaluate the efficacy of gentamicin solution in transurethral ureteroscopie lithotripsy to prevent postoperative infection. Methods Prospective clinical randomized control study was conducted. From July 2003 to June 2006, 116 cases of ureteral stones at high risk of postoperative infection were randomized into control group or gentamicin group. Patients in gentamicin group received gentamicin solution for washing in the operation. All the patients undergoing operation were followed up for 2 weeks after operation. Diagnosis of postoperative infection was based on clinical manifestations. Results A total of 109 patients received operation in all the 116 cases, including 58 cases in gentamicin group and 51 cases in control group. Thirteen cases of postoperative infection were identified in all the patients receiving operation （11.93 %）, 3 cases in gentamicin group and 10 in control group. The incidence of postoperative infection was significantly different between the two groups （ Х^2 = 5. 3342, P = 0. 0209）. Eight cases had positive bacterial culture. Of the microbiological isolates, 2 were gram-positive bacteria, 5 gram-negative bacteria and 1 Candida albicans. Conclusions The most common pathogen causing postoperative infection after transurethral ureteroscopic lithotripsy is gram-negative bacteria. The use of gentamicin solution for washing in the operation can reduce the incidence of postoperative infection.
出处
《中国感染与化疗杂志》
CAS
2007年第5期359-361,共3页
Chinese Journal of Infection and Chemotherapy
关键词
庆大霉素
术后感染
输尿管镜
输尿管结石
Gentamicin
Postoperative infection
Ureteroscope
Ureteral calculus
