本文選題：經(jīng)尿道前列腺切除術(shù)　切入點(diǎn)：泌尿系統(tǒng)感染　出處：《中華醫(yī)院感染學(xué)雜志》2017年21期 　論文類型：期刊論文

【摘要】：目的探討經(jīng)尿道前列腺切除術(shù)(TURP)患者術(shù)后泌尿系感染的病原菌分布及藥敏特征,并分析感染的危險(xiǎn)因素及護(hù)理對(duì)策,根據(jù)相關(guān)因素制定預(yù)防和控制措施,以期降低感染率。方法選取2011年4月-2016年4月480例良性前列腺增生癥(BPH)并接受TURP治療的患者納入研究,分析患者泌尿系統(tǒng)感染率、耐藥菌分布、藥敏特征及相關(guān)危險(xiǎn)因素。結(jié)果 480例BPH患者術(shù)后發(fā)生泌尿系統(tǒng)感染76例,感染率為15.8%;76例患者標(biāo)本中共分離出病原菌80株,其中革蘭陰性菌44株,占55.0%,革蘭陽(yáng)性菌34株,占42.5%,真菌2株,占2.5%;革蘭陰性菌中大腸埃希菌對(duì)氨芐西林耐藥率最高為88.9%,銅綠假單胞菌對(duì)頭孢唑林耐藥率最高為50.0%,二者均對(duì)亞胺培南敏感;革蘭陽(yáng)性菌中表皮葡萄球菌對(duì)青霉素的耐藥率最高為60%,對(duì)萬(wàn)古霉素敏感;患者年齡≥60歲、合并糖尿病、合并高血壓、術(shù)前導(dǎo)尿、前列腺≥30g、手術(shù)時(shí)間≥1h、術(shù)后導(dǎo)尿管留置時(shí)間3d、術(shù)前應(yīng)用抗菌藥物是TURP術(shù)后發(fā)生泌尿系感染的相關(guān)因素;多因素Logistic回歸分析顯示合并糖尿病(OR=2.412,95%CI:0.378~8.207)、術(shù)前未應(yīng)用抗菌藥物(OR=3.374,95%CI:1.977~16.884)、術(shù)前導(dǎo)尿(OR=3.579,95%CI:0.884~9.693)以及術(shù)后導(dǎo)尿管留置時(shí)間3d(OR=2.864,95%CI:1.413~10.442)是TURP術(shù)后發(fā)生泌尿系感染的獨(dú)立危險(xiǎn)因素(P0.05)。結(jié)論應(yīng)針對(duì)TURP術(shù)后發(fā)生泌尿系感染的高危因素,加強(qiáng)基礎(chǔ)護(hù)理及專科護(hù)理,最大程度降低感染率。
[Abstract]:Objective to investigate the distribution of pathogenic bacteria and drug sensitivity in patients with urinary tract infection after transurethral prostatectomy (TURP), analyze the risk factors of infection and nursing countermeasures, and formulate prevention and control measures according to the relevant factors. Methods from April 2011 to April 2016, 480 patients with benign prostatic hyperplasia (BPH) treated with TURP were included in the study, and the urinary system infection rate and the distribution of drug-resistant bacteria were analyzed. Results there were 76 cases of urinary tract infection in 480 patients with BPH, and the infection rate was 15.876 cases. A total of 80 strains of pathogenic bacteria were isolated, among which 44 strains were Gram-negative bacteria (55.0%), 34 strains were Gram-positive bacteria. Among Gram-negative bacteria, Escherichia coli had the highest resistance rate to ampicillin, while Pseudomonas aeruginosa to cefazolin had the highest resistance rate to cefazolin, both of which were sensitive to imipenem. Among Gram-positive bacteria, Staphylococcus epidermidis had the highest resistance to penicillin and was sensitive to vancomycin. Prostatic gland 鈮，

本文編號(hào)：1557638