Division of Clinical Cancer Epidemiology, Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden.
BJU Int. 2010 Apr;105(8):1107-17. doi: 10.1111/j.1464-410X.2009.08909.x. Epub 2009 Oct 23.
To determine whether or not an improved hygiene can lessen the incidence of symptomatic urinary tract infections (UTIs) in patients treated by cystectomy for urinary bladder cancer.
We attempted to contact during their follow-up all men and women aged 30-80 years who had undergone cystectomy and urinary diversion at seven Swedish hospitals. During a qualitative phase we identified hygienic measures and included them in a study-specific questionnaire. The patients completed the questionnaire at home. Outcome variables were dichotomized and the results presented as relative risks (RR) with 95% confidence interval.
We received the questionnaire from 452 (92%) of 491 identified patients. The proportion of patients who had a symptomatic UTI in the previous year was 22% for orthotopic neobladder and cutaneous continent reservoir, and 23% for non-continent urostomy diversion. The RR for a UTI was 1.1 (0.5-2.5) for 'never washing hands' before handling with catheters or ostomy material. Patients with diabetes mellitus had a RR of 2.1 (1.4-3.2) for having a symptomatic UTI.
We could not confirm lack of hygiene measures as a cause of UTI for men and women who had a cystectomy with urinary diversion. Patients with diabetes mellitus have a greater risk of contracting a UTI.
确定改善卫生习惯是否能降低接受膀胱癌膀胱切除术治疗的患者发生有症状尿路感染（UTI）的发生率。
我们试图在随访期间联系瑞典七家医院所有年龄在 30-80 岁之间接受过膀胱切除术和尿路改道的男性和女性患者。在定性阶段，我们确定了卫生措施，并将其纳入专门的研究问卷中。患者在家中完成问卷。将结局变量二分为两类，并以相对风险（RR）及其 95%置信区间表示结果。
我们从 491 名确定的患者中收到了 452 份（92%）问卷。在前一年中有症状 UTI 的患者比例为：原位新膀胱和皮肤连续性储尿袋为 22%，非连续性尿流改道术为 23%。在处理导管或造口材料前“从不洗手”的患者发生 UTI 的 RR 为 1.1（0.5-2.5）。患有糖尿病的患者发生有症状 UTI 的 RR 为 2.1（1.4-3.2）。
我们无法确认对于接受膀胱切除术和尿路改道的男性和女性患者来说，卫生习惯不良是 UTI 的原因。患有糖尿病的患者更容易发生 UTI。
