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[尿道膀胱镜检查后发生的泌尿生殖系统感染的治疗与预防]

[Treatment and prophylaxis for urogenital infections occurring after urethrocystoscopy].

作者信息

Ohishi Y, Machida T, Akasaka Y, Tashiro K, Kiyota H, Goto H, Saito K

机构信息

Department of Urology, Jikei University School of Medicine.

出版信息

Hinyokika Kiyo. 1988 Sep;34(9):1601-5.

PMID:3213795
Abstract

To prevent urogenital infections occurring after urethrocystoscopy, we have studied the prevalence of these diseases without the use of antibiotic agents subsequent to urethrocystoscopy to determine the relative importance of aseptic procedures and whether administration of antibiotics is really required for this purpose. Patients enrolled in the present study included those undergoing urethrocystoscopy at four hospitals, totaling 146 patients (93 male and 53 female patients). All of these patients were apparently free of urogenital infections prior to urethrocystoscopy, with less than 5 leucocytes per field in urinary sediment, and a bacteria count of less than 10(4) cells/ml. Each patient was checked between 3 and 14 days after examination for 1) presence of clinical symptoms such as fever, bladder irritation symptoms and urethral secretion, 2) urinalysis and urinary culture, and 3) palpation of epididymis, testis and prostatic gland as required. The endoscope was sterilized for 20 to 30 minutes with 2% glutaraldehyde at 3 clinical institutions and with 0.5% chlorhexidine at the other, in a total of 116 and 30 patients, respectively. Sterilized distilled water was used as perfusate. The external urethral meatus of the subject was disinfected with 0.5% chlorhexidine, followed by local anesthesia with xylocaine jelly. Ten minutes after disinfecting the hands of the examiner, urethroscopy and cystoscopy were performed in this order. Urinary tract infection was detected in one male patient (1.1%) and 2 female patients (3.3%). In these cases, the endoscope was sterilized with glutaraldehyde in 2 cases and with chlorhexidine in the other. None of the subjects demonstrated fever or genital infections.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

为预防尿道膀胱镜检查后发生泌尿生殖系统感染,我们研究了在不使用抗生素的情况下这些疾病的发生率,以确定无菌操作的相对重要性,以及为此目的是否真的需要使用抗生素。本研究纳入的患者包括在四家医院接受尿道膀胱镜检查的患者,共146例(男性93例,女性53例)。所有这些患者在尿道膀胱镜检查前显然没有泌尿生殖系统感染,尿沉渣每视野白细胞少于5个,细菌计数少于10⁴个/ml。在检查后3至14天对每位患者进行检查,包括:1)是否存在发热、膀胱刺激症状和尿道分泌物等临床症状;2)尿液分析和尿培养;3)根据需要触诊附睾、睾丸和前列腺。在3家临床机构,分别有116例和30例患者,使用2%戊二醛对内镜进行20至30分钟消毒,另一家使用0.5%氯己定消毒。使用经过消毒的蒸馏水作为灌注液。用0.5%氯己定对受检者的尿道外口进行消毒,然后用利多卡因凝胶进行局部麻醉。检查者手部消毒10分钟后,按此顺序进行尿道镜检查和膀胱镜检查。1例男性患者(1.1%)和2例女性患者(3.3%)检测到尿路感染。在这些病例中,2例使用戊二醛对内镜进行消毒,另1例使用氯己定消毒。所有受检者均未出现发热或生殖器感染。(摘要截短至250字)

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