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日本泌尿外科领域围手术期感染预防指南。

Japanese guidelines for prevention of perioperative infections in urological field.

作者信息

Matsumoto Tetsuro, Kiyota Hiroshi, Matsukawa Masanori, Yasuda Mitsuru, Arakawa Soichi, Monden Koichi

机构信息

Department of Urology, University of Occupational and Environmental Health, Kitakyushu, Japan.

出版信息

Int J Urol. 2007 Oct;14(10):890-909. doi: 10.1111/j.1442-2042.2007.01869.x.

Abstract

For urologists, it is very important to master surgical indications and surgical techniques. On the other hand, the knowledge of the prevention of perioperative infections and the improvement of surgical techniques should always be considered. Although the prevention of perioperative infections in each surgical field is a very important issue, the evidence and the number of guidelines are limited. Among them, the preparation of guidelines has progressed, especially in gastrointestinal surgery. The Center for Disease Control and Prevention (CDC) proposed guidelines for the prevention of surgical site infections, which have been used worldwide. In urology, the original guidelines were different from those of general surgery, due to many endourological procedures and urine exposure in the surgical field. The Japanese Society of UTI Cooperative Study Group has thus framed these guidelines supported by The Japanese Urological Association. The guidelines consist of the following nine techniques: open surgeries, laparoscopic surgeries, transurethral resection of bladder tumor, ureterorenoscope and transurethral lithotripsy, transurethral resection of the prostate, prostate biopsy, cystourethroscope, pediatric surgeries in the urological field, and extracorporeal shock wave lithotripsy and febrile neutropenia. These are the first guidelines for the prevention of perioperative infections in the urological field in Japan. Although most of these guidelines were made using reliable evidence, there are parts without enough evidence. Therefore, if new reliable data is reported, it will be necessary for these guidelines to be revised in the future.

摘要

对于泌尿外科医生而言,掌握手术适应症和手术技巧非常重要。另一方面,始终应考虑围手术期感染预防的知识以及手术技巧的改进。尽管每个手术领域围手术期感染的预防都是一个非常重要的问题,但相关证据和指南数量有限。其中,指南的制定已经取得进展,尤其是在胃肠外科领域。美国疾病控制与预防中心(CDC)提出了手术部位感染预防指南,已在全球范围内使用。在泌尿外科,由于许多腔内泌尿外科手术以及手术视野中尿液暴露,其原始指南与普通外科不同。因此,日本泌尿道感染合作研究组在日本泌尿外科学会的支持下制定了这些指南。这些指南包括以下九种技术:开放手术、腹腔镜手术、膀胱肿瘤经尿道切除术、输尿管肾镜检查及经尿道碎石术、前列腺经尿道切除术、前列腺活检、膀胱尿道镜检查、泌尿外科领域的小儿手术以及体外冲击波碎石术和发热性中性粒细胞减少症。这些是日本泌尿外科领域围手术期感染预防的首批指南。尽管这些指南大多是基于可靠证据制定的,但仍有部分内容缺乏足够证据。因此,如果有新的可靠数据报道,未来有必要对这些指南进行修订。

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