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积习难改;肾移植后早期拔除导尿管会影响肾脏大小、菌尿症和尿路感染吗?

Old habits die hard; does early urinary catheter removal affect kidney size, bacteriuria and UTI after renal transplantation?

作者信息

Akbari Roghayeh, Rahmani Firouzi Sedigheh, Akbarzadeh-Pasha Abazar

机构信息

Clinical Research Development Unit, Ayatollah Rohani Hospital, Babol University of Medical Sciences, Babol, Iran.

Babol University of Medical Sciences, Babol, Iran.

出版信息

J Renal Inj Prev. 2016 Nov 20;6(1):43-48. doi: 10.15171/jrip.2017.08. eCollection 2017.

Abstract

Renal transplantation is the treatment of choice in chronic renal failure patients. The purpose of this study was to evaluate the impact of urinary catheter removal time on transplanted kidney size and incidence of asymptomatic bacteriuria and urinary tract infections (UTIs). This retrospective cohort study evaluated the clinical outcomes of 109 consecutive live donor renal transplant recipients from December 2011 to July 2014. Routine ultrasound examinations were performed on donor's kidney prior to operation and one month later. Kidney volume was calculated. UTI and bacteriuria were evaluated one month later. Patients were divided into two groups based on time of Foley catheter removal (before and after fifth day posttransplantation). In this study 74 males (67.9%) and 35 females (32.1%) were evaluated. Sixty-six patients (57.92%) were in group 1. None of the patients with positive urine culture had UTI but bacteriuria occurred in all of them (21.1%). Bacteriuria time after transplantation and catheter removal was significantly later in group 1 and it was not different in female group but they were later in male group. The mean renal volume increase was positively correlated to renal transplant recipient and donor's age and donor's body mass index (BMI) (<0.05). This study showed that the time of catheter removal after kidney transplantation does not affect incidence of UTI but increases the probability of bacteria in men whose catheter was removed within 5 days after transplantation. We also found that the renal volume change is not associated with catheter removal time and bacteriuria.

摘要

肾移植是慢性肾衰竭患者的首选治疗方法。本研究的目的是评估拔除尿管时间对移植肾大小以及无症状菌尿和尿路感染(UTI)发生率的影响。这项回顾性队列研究评估了2011年12月至2014年7月期间109例连续的活体供肾肾移植受者的临床结局。在术前及术后1个月对供肾进行常规超声检查,计算肾脏体积。术后1个月评估UTI和菌尿情况。根据拔除Foley尿管的时间(移植后第5天之前和之后)将患者分为两组。本研究共评估了74例男性(67.9%)和35例女性(32.1%)。66例患者(57.92%)在第1组。尿培养阳性的患者均无UTI,但所有患者(21.1%)均发生了菌尿。第1组移植后及拔除尿管后的菌尿发生时间明显较晚,女性组无差异,但男性组较晚。移植肾平均体积增加与肾移植受者及供者的年龄和供者体重指数(BMI)呈正相关(<0.05)。本研究表明,肾移植后拔除尿管的时间不影响UTI的发生率,但增加了移植后5天内拔除尿管男性的细菌感染概率。我们还发现,肾体积变化与拔除尿管时间和菌尿无关。

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Cochrane Database Syst Rev. 2018 Feb 1;2(2):CD011357. doi: 10.1002/14651858.CD011357.pub2.

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