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目的探讨前列腺增生患者经尿道前列腺切除术(TURP)术后发生顽固性尿路感染的临床机制,为该类疾病的诊治提供理论参考。方法回顾性分析2006年1月-2010年6月127例TURP术后顽固性尿路感染患者的临床特征和尿液培养资料。结果前列腺增生患者TURP术后顽固性尿路感染占6.43%;127例尿路感染患者中有61例存在手术及局部解剖结构的异常,占48.03%,多伴有糖尿病等合并症;在分离的病原菌中革兰阴性菌占主要地位,103株,占81.10%,其中以大肠埃希菌最为常见;β-内酰胺酶测定阳性率达61.41%,对亚胺培南等抗菌药物具有良好敏感性,为98.43%。结论 TURP术后顽固性尿路感染有其全身和局部诱因,规范手术操作去除诱因,依据尿培养药敏结果指导临床选用抗菌药物是预防此类疾病的有效手段。
Objective To investigate the clinical mechanism of intractable urinary tract infection after transurethral resection of the prostate (TURP) in patients with benign prostatic hyperplasia (BPH) and to provide a theoretical reference for the diagnosis and treatment of such diseases. Methods The clinical features and urine culture of 127 patients with refractory urinary tract infection after TURP were retrospectively analyzed from January 2006 to June 2010. Results The patients with benign prostatic hyperplasia had intractable urinary tract infection after TURP accounting for 6.43%. There were 61 cases of urinary tract infection in 61 cases with abnormalities of operation and local anatomy, accounting for 48.03%, with complications such as diabetes. In the isolated Gram-negative bacteria in pathogens accounted for the main position, 103 strains, accounting for 81.10%, of which the most common Escherichia coli; β-lactamase assay positive rate of 61.41%, imipenem and other antibiotics have good sensitivity , 98.43%. Conclusion TURP intractable urinary tract infection has its systemic and local causes, standard surgical operation to remove incentives, based on the sensitivity of urine culture to guide the clinical use of antimicrobial agents is an effective means to prevent such diseases.