本文選題：尿路感染　切入點(diǎn)：有機(jī)硅季銨鹽　出處：《暨南大學(xué)》2013年碩士論文　論文類(lèi)型：學(xué)位論文

【摘要】：目的:通過(guò)臨床試驗(yàn)置入被覆物理抗菌膜的輸尿管支架管，，研究物理抗菌材料防治輸尿管支架管留置引起感染的作用。 方法：開(kāi)展臨床研究60例，分為觀察組和對(duì)照組兩組，觀察組予輸尿管鏡碎石術(shù)后置入物理抗菌材料組輸尿管支架管。對(duì)照組置入未予特殊處理的同公司同批次輸尿管支架管。比較兩組患者術(shù)后導(dǎo)管留置相關(guān)感染臨床表現(xiàn)以及記錄兩組患者術(shù)后實(shí)驗(yàn)室檢查(尿白細(xì)胞、尿培養(yǎng)，CRP(C反應(yīng)蛋白Creativeprotein)、PCT（降鈣素原procalcitonin）比較兩組間有無(wú)差別。 結(jié)果：所有患者均順利完成輸尿管鏡碎石術(shù)，在納入實(shí)驗(yàn)組的患者中，術(shù)后3天、7天、14天、28天尿路感染的發(fā)生率分別為3.3%、6.7%、6.7%、16.7%。對(duì)照組術(shù)后3天、7天、14天、28天尿路感染的發(fā)生率分別為6.7%、20%、30%、43.3%。術(shù)后3天實(shí)驗(yàn)組和對(duì)照組尿路感染的發(fā)生率相差不大，而術(shù)后7天、14天、28天尿路感染發(fā)生率實(shí)驗(yàn)組比對(duì)照組明顯低（P＜0.05）。實(shí)驗(yàn)組中CRP、PCT、尿白細(xì)胞計(jì)數(shù)等實(shí)驗(yàn)室檢查在術(shù)后3天與對(duì)照組相差不大（P＜0.05），術(shù)后7天、14天、28天實(shí)驗(yàn)組CRP、PCT及尿中白細(xì)胞計(jì)數(shù)均比對(duì)照組低（P＜0.05）。隨著輸尿管支架管留置時(shí)間的延長(zhǎng)兩組尿路感染的發(fā)生率增高，對(duì)照組發(fā)病率增高趨勢(shì)比試驗(yàn)組明顯。 結(jié)論:通過(guò)臨床研究證實(shí)，置入經(jīng)過(guò)被覆有機(jī)硅季銨鹽物理抗菌材料處理的輸尿管支架管，與置入未經(jīng)處理的輸尿管支架管對(duì)比，能夠有效的避免及減輕導(dǎo)管留置相關(guān)感染的發(fā)生率。
[Abstract]:Objective: to study the effect of physical antimicrobial materials on ureteral stents in the treatment of ureteral stents. Methods: sixty cases of clinical study were divided into two groups: observation group and control group. The observation group was treated with ureteroscopic lithotripsy and physical antibacterial material was placed in the ureteral stent tube. The control group was treated with the same batch of ureteral stents without special treatment. The infection associated with catheter indwelling was compared between the two groups. Bed manifestations and postoperative laboratory examinations (urine leukocytes) were recorded in both groups. There was no difference between the two groups in urine culture CRP C-reactive protein and PCT (procalcitonin). Results: all patients successfully completed ureteroscopic lithotripsy. The incidence of urinary tract infection in the control group was 6.77.The incidence of urinary tract infection in the control group was 6.70.The incidence of urinary tract infection on the 3rd day, the 7th day, the 14th day, the 28th day after operation in the control group was 6.70.The incidence of urinary tract infection in the experimental group and the control group was similar to that in the control group on the 3rd day after operation. The incidence of urinary tract infection in the experimental group was significantly lower than that in the control group on the 7th and 14th day after operation (P < 0.05). The laboratory examination of CRPnPCT and urine white blood cell count in the experimental group was not significantly different from that in the control group on the 3rd day after operation (P < 0.05), and on the 14th day after operation, it was 28 days after the operation in the experimental group (P < 0.05). WBC count in urine was lower than that in control group (P < 0.05). The incidence of urinary tract infection increased with the prolongation of ureteral stent indwelling time. The increasing trend of incidence in the control group was more obvious than that in the experimental group. Conclusion: it is proved by clinical study that ureteral stents treated with organic quaternary ammonium salt and untreated ureteral stents are better than untreated ureteral stents. Can effectively avoid and reduce the incidence of catheter indwelling associated infections.
【學(xué)位授予單位】：暨南大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2013
【分類(lèi)號(hào)】：R318.08;R699.4

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