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肾移植中支架内输尿管膀胱吻合术:会影响尿路感染的发生率吗?

Stented ureterovesical anastomosis in renal transplantation: does it influence the rate of urinary tract infections?

机构信息

Department of General-, Visceral- and Transplantation Surgery, University Hospital of Essen, Hufelandstrasse 55, 45122 Essen, Germany.

出版信息

Eur J Med Res. 2010;15(7):297-302. doi: 10.1186/2047-783x-15-7-297.

Abstract

OBJECTIVE

Our objective was to evaluate the impact of routine use of double-J stents on the incidence of urinary tract infection after renal transplantation.

METHODS

We conducted a retrospective-comparative single-centre study in 310 consecutive adult deceased donor kidney recipients transplanted from 2002 to 2006. Patients were divided in two groups, with or without urinary stent implantation. To evaluate the predictive factors for UTI, donor and recipients pre- and post-transplantation data were analysed. Early urological complications and renal function within 12 months of transplantation were included as well.

RESULTS

A total of 157 patients were enrolled to a stent (ST) and 153 patients to a no-stent (NST) group. The rate of urinary tract infection at three months was similar between the two groups (43.3% ST vs. 40.1% NST, p = 0.65). Of the identified pathogens Enterococcus and Escherichia coli were the most common species. In multivariate analysis neither age nor immunosuppressive agents, BMI or diabetes seemed to have influence on the rate of UTI. When compared to males, females had a significantly higher risk for UTI (54.0% vs. 33.5%).

CONCLUSION

Prophylactic stenting of the ureterovesical anastomosis does not increase the risk of urinary tract infection in the early postoperative period.

摘要

目的

我们旨在评估常规使用双 J 支架对肾移植后尿路感染发生率的影响。

方法

我们进行了一项回顾性、单中心的研究,纳入了 2002 年至 2006 年间连续接受 310 例成人尸体供肾移植的患者。患者分为两组,一组使用输尿管支架,另一组未使用。为了评估尿路感染的预测因素,分析了供体和受体移植前和移植后的数据。还包括了早期泌尿科并发症和移植后 12 个月内的肾功能。

结果

共纳入 157 例使用支架(ST)的患者和 153 例未使用支架(NST)的患者。两组在三个月时的尿路感染率相似(43.3% ST 与 40.1% NST,p=0.65)。在已鉴定的病原体中,肠球菌和大肠杆菌是最常见的物种。在多变量分析中,年龄以及免疫抑制剂、BMI 或糖尿病似乎都没有影响尿路感染的发生率。与男性相比,女性发生尿路感染的风险显著更高(54.0% vs. 33.5%)。

结论

预防性放置输尿管-膀胱吻合口支架不会增加术后早期尿路感染的风险。

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