Hansen M, Genster H G, Thordsen C
Department of Surgery K, Sønderborg Hospital, Denmark.
Scand J Urol Nephrol Suppl. 1987;104:65-8.
The study evaluates the incidence and consequences of infectious complications after 700 transurethral resections of the prostate. The patients were treated individually for bacteriuria according to urine cultures. No general antibacterial prophylaxis was used. 376 patients (54%) had negative urine cultures throughout the course and received no antibacterials. Of the 256 patients with an indwelling catheter before surgery only 64 (25%) had negative cultures throughout, as opposed to 312 (70%) out of 444 patients without an indwelling catheter preoperatively. Antibacterial treatment was given to 127 patients (18%) before surgery because of bacteriuria. Positive urine cultures postoperatively indicated antibacterial therapy to 197 patients (28%). Four non-fatal cases of septicemia were recorded. The influence of bacteriuria and indwelling catheters on the postoperative course and on the length of hospital stay is documented. It is concluded that antibiotic prophylaxis may be indicated in patients with a preoperative urethral catheter; other patients should be treated if and when bacteriuria occurs.
该研究评估了700例经尿道前列腺切除术后感染性并发症的发生率及后果。根据尿培养结果对患者的菌尿症进行个体化治疗。未使用全身性抗菌预防措施。376例患者(54%)在整个病程中尿培养结果为阴性,未接受抗菌药物治疗。在术前留置导尿管的256例患者中,只有64例(25%)在整个病程中培养结果为阴性,而术前未留置导尿管的444例患者中有312例(70%)培养结果为阴性。127例患者(18%)因菌尿症在术前接受了抗菌治疗。术后尿培养结果阳性表明有197例患者(28%)接受了抗菌治疗。记录到4例非致命性败血症病例。记录了菌尿症和留置导尿管对术后病程及住院时间的影响。得出的结论是,对于术前留置尿道导管的患者可能需要进行抗生素预防;其他患者如果发生菌尿症应及时治疗。