上尿路结石感染的病原学特征及即刻引流效果分析

Etiological characteristics of upper urinary tract stone infection and effect of immediate drainage

  • 摘要:
      目的  观察上尿路结石感染的病原学特征及术后即刻引流的治疗效果。
      方法  回顾性分析100例上尿路结石感染患者的临床资料, 调查患者病原菌感染类型并针对常见菌属进行药敏试验分析,患者手术后均接受即刻引流,观察即刻引流的治疗效果。
      结果  100例上尿路结石感染患者中, 58.00%为革兰阴性菌感染, 31.00%为革兰阳性菌感染, 11.00%为真菌感染。药敏试验结果显示,大肠埃希菌对氨苄西林、头孢唑啉、头孢曲松和诺氟沙星耐药性较高,对头孢哌酮舒巴坦、阿米卡星敏感性较高; 粪肠球菌对庆大霉素、青霉素G和红霉素耐药性较高,对万古霉素、替考拉宁和氨苄西林敏感性较高。100例患者均顺利完成手术,引流后均未发生感染性休克、败血症和大出血等并发症; 治疗后1、2、3 d, 患者体温、白细胞、中性粒细胞百分比、C反应蛋白、降钙素原和白细胞介素-6水平低于治疗前,差异有统计学意义(P<0.05)。
      结论  上尿路结石感染患者的病原菌以革兰阴性菌为主,术后即刻引流能尽快控制感染,减少败血症、感染性休克等并发症的发生。

     

    Abstract:
      Objective  To observe etiological characteristics of upper urinary tract stone infection and effect of immediate drainage after operation.
      Methods  The clinical data of 100 patients with upper urinary tract stone infections were retrospectively analyzed. The types of patients' pathogenic bacteria infection were investigated and drug sensitivity test was conducted for common bacteria. All patients received immediate drainage after surgery, and the therapeutic effect of immediate drainage was observed.
      Results  Among 100 patients with upper urinary tract calculi infection, 58.00% were Gram-negative bacteria infection, 31.00% were Gram-positive bacteria and 11.00% were fungal infection. The drug sensitivity test showed that Escherichia coli had high resistance to ampicillin, ceftriaxone and norfloxacin, and high sensitivity to cefoperazone, sulbactam and amikacin; Enterococcus faecalis was highly resistant to gentamicin, penicillin G and erythromycin, and highly sensitive to vancomycin, teicoplanin and ampicillin. At the same time, all patients successfully completed the operation, and there were no accidents such as septic shock and massive hemorrhage after drainage. The body temperature, leukocyte, neutrophil percentage, C-reactive protein (CRP), procalcitonin and interleukin-6 levels at each time (1, 2, 3 d) points after treatment were lower than those before treatment (P < 0.05).
      Conclusion  Postoperative infections of upper urinary tract stones are predominantly infected by Gram-negative bacteria. Immediate drainage after surgery can control infection as soon as possible and reduce incidence of complications such as sepsis and septic shock.

     

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