Kanjanawongdeengam Panupong, Viseshsindh Wit, Santanirand Pitak, Prathombutr Prapapan, Nilkulwattana Supannee
Division of Urology, Department of Surgery, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
J Med Assoc Thai. 2009 Dec;92(12):1621-6.
To determine the efficacy of rectum sterilization before TRUS guided prostate biopsy in order to decrease bacteremia rate and sepsis complication.
From August 2008 to March 2009, 100 volunteers who had an indication for prostate biopsy were recruited into the present study in a randomized controlled trial. The present study was approved by the Ethics Committee on Human Experimentation of Ramathibodi Hospital Faculty of Medicine, Mahidol University. The volunteers received unison enema one day before and Ciprofloxacin 500 mg 0.5-1 hr before the procedure. These 100 volunteers were divided into two groups; 50 were randomly assigned in the group of rectum cleaning with 10% povidone-iodine, whereas the other 50 volunteers were placed in the control group. Twelve cores of TRUS guided prostate biopsy were performed After the procedure, peripheral blood samples were taken for cultures for aerobic and anaerobic bacteria. A clinical follow-up at 48-72 hrs after the procedure was done via telephone.
Hemocultures were positive for 9 cases in the rectum cleaning group and 2 cases in the control group (p = 0.025). Three volunteers (one in the rectum cleaning group and two in the control group) had a postoperative fever but it spontaneously resolved. Two volunteers in the control group came back to the hospital because of urinary tract infections and rectal bleeding. None of the volunteers had clinical sepsis or went to other hospitals.
Sterilization of the rectum before TRUS guided prostate biopsy was found to reduce postoperative bacteremia and might reduce clinical infections.
确定经直肠超声引导下前列腺活检前进行直肠消毒以降低菌血症发生率和脓毒症并发症的疗效。
2008年8月至2009年3月，100名有前列腺活检指征的志愿者被纳入本随机对照试验研究。本研究经玛希隆大学拉玛蒂博迪医院医学院人体实验伦理委员会批准。志愿者在操作前一天接受统一灌肠，并在操作前0.5 - 1小时服用500毫克环丙沙星。这100名志愿者被分为两组；50名被随机分配到用10%聚维酮碘清洁直肠的组，而另外50名志愿者被置于对照组。进行经直肠超声引导下的前列腺活检，取12个组织芯。操作后，采集外周血样本进行需氧菌和厌氧菌培养。操作后48 - 72小时通过电话进行临床随访。
直肠清洁组9例血培养阳性，对照组2例（p = 0.025）。3名志愿者（直肠清洁组1名，对照组2名）术后发热，但自行缓解。对照组2名志愿者因尿路感染和直肠出血返回医院。没有志愿者发生临床脓毒症或前往其他医院。
经直肠超声引导下前列腺活检前进行直肠消毒可降低术后菌血症发生率，并可能减少临床感染。
