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蔓越莓胶囊预防盆腔手术后医院内泌尿道细菌尿:一项随机对照试验。

Cranberry capsules to prevent nosocomial urinary tract bacteriuria after pelvic surgery: a randomised controlled trial.

机构信息

Department of Obstetrics and Gynaecology, Nimes University Hospital, Nîmes, France.

Department of Biostatistics, Epidemiology, Public Health and Bio-informatics, Nîmes University Hospital, Nîmes, France.

出版信息

BJOG. 2017 May;124(6):912-917. doi: 10.1111/1471-0528.14524. Epub 2017 Feb 10.

DOI:10.1111/1471-0528.14524
PMID:28186383
Abstract

OBJECTIVE

To evaluate whether cranberries are able to prevent postoperative urinary bacteriuria in patients undergoing pelvic surgery and receiving transurethral catheterisation.

DESIGN

Randomised, double-blind, placebo-controlled trial.

SETTINGS

French tertiary Care centre, University Hospital.

POPULATION

A total of 272 women undergoing pelvic surgery aged 18 or older.

METHODS

Participants undergoing pelvic surgery were randomised to 36 mg cranberry (proanthocyanidins, PAC) or placebo once daily for 10 days. Statistical analysis was performed by a chi-square test.

MAIN OUTCOME MEASURES

The primary and secondary outcomes were postoperative bacteriuria, defined by a positive urine culture, within the first 15 and 40 days, respectively.

RESULTS

Two hundred and fifty-five participants received the intended treatment: 132 (51.8%) received PAC and 123 (48.2%) received placebo. There were no significant differences in baseline demographics, intra-operative characteristics or duration and type of catheterisation between the two groups. PAC prophylaxis did not reduce the risk of bacteriuria treatment within 15 days of surgery [27% bacteriuria with PAC compared with 25% bacteriuria with placebo: relative risk 1.05, 95% CI 0.78-1.4, P = 0.763). The same result was observed on day 40. Bacteriuria occurred more often in older women with increased length of catheterisation.

CONCLUSION

Immediate postoperative prophylaxis with PAC does not reduce the risk of postoperative bacteriuria in patients receiving short-term transurethral catheterisation after pelvic surgery.

TWEETABLE ABSTRACT

PAC prophylaxis does not reduce the risk of postoperative bacteriuria in patients undergoing pelvic surgery.

摘要

目的

评估蔓越莓是否能预防接受盆腔手术和经尿道导尿的患者术后尿细菌尿。

设计

随机、双盲、安慰剂对照试验。

地点

法国三级保健中心,大学医院。

人群

共 272 名年龄在 18 岁及以上的接受盆腔手术的女性。

方法

接受盆腔手术的患者被随机分为每天服用 36mg 蔓越莓(原花青素,PAC)或安慰剂一次,共 10 天。统计分析采用卡方检验。

主要观察指标

主要和次要结局分别为术后 15 天和 40 天内首次出现的尿细菌培养阳性的术后细菌尿。

结果

255 名参与者接受了意向治疗:132 名(51.8%)接受 PAC 治疗,123 名(48.2%)接受安慰剂治疗。两组患者的基线人口统计学、术中特征或导管插入的持续时间和类型均无显著差异。PAC 预防并不能降低术后 15 天内发生细菌尿的风险[PAC 组 27%的细菌尿,安慰剂组 25%的细菌尿:相对风险 1.05,95%CI 0.78-1.4,P=0.763]。第 40 天也是如此。细菌尿更常发生在导管插入时间较长的老年女性中。

结论

在接受盆腔手术后短期经尿道导尿的患者中,即刻术后使用 PAC 预防并不能降低术后细菌尿的风险。

推文摘要

PAC 预防并不能降低接受盆腔手术患者术后细菌尿的风险。

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