肾结石患者尿路真菌感染的临床防治研究

发布时间：2018-04-23 20:03

本文选题：肾结石 + 真菌　；参考：《中华医院感染学杂志》2015年14期

【摘要】：目的研究肾结石患者尿路真菌感染诱因以及真菌分布特点,以降低感染率。方法将2009年12月-2013年12月就诊的643例复杂性肾结石患者的中段尿进行培养,根据是否并发感染将复杂性肾结石患者分为真菌感染组32例和非感染组611例,对真菌感染的患者给予微创经皮肾镜取石术(MPCNL)治疗,采集中段尿进行真菌药敏试验,分析导致尿路感染的相关因素。结果 643例复杂性肾结石患者发生真菌尿路感染32例,感染率4.98%,送检标本检出白色假丝酵母菌23株占71.88%,隐球酵母菌属9株占28.12%;32例真菌尿路感染患者均有反复长期使用广谱抗菌药物病史;术后复杂性结石完全清除率为93.75%,疗效明显,术后肾功能得到不同程度的恢复,患者未出现大出血和真菌败血症等并发症。结论复杂性肾结石易并发真菌感染,应合理使用广谱抗菌药物,缩短患者术后留置导管的时间,对于复杂性结石并发真菌感染的患者采用MPCNL治疗,其疗效明显,具有安全性高、并发症少的特点。
[Abstract]:Objective to study the causes and distribution of urinary fungal infection in patients with renal calculi in order to reduce the infection rate. Methods from December 2009 to December 2013, 643 patients with complicated renal calculi were divided into fungal infection group (n = 32) and non-infected group (n = 611). Patients with fungal infection were treated with minimally invasive percutaneous nephrolithotomy (MPCNL). Results 32 cases of fungal urinary tract infection occurred in 643 patients with complicated renal calculi. The infection rate was 4.98. 23 strains of Candida albicans were detected in the specimens, and 9 strains of Cryptococcus were found in 28.1212 cases. 32 patients with urinary tract infection of fungi all had a history of repeated use of broad-spectrum antimicrobial agents, the complete clearance rate of postoperative complex stones was 93.75, and the curative effect was obvious. The renal function recovered in different degree after operation, and no complications such as massive hemorrhage and fungal septicemia were found in the patients. Conclusion complex renal calculi are easy to be complicated with fungal infection. It is necessary to reasonably use broad-spectrum antibiotics and shorten the time of indwelling catheter after operation. MPCNL is effective and safe for patients with complicated stone complicated with fungal infection. The characteristic of less complications.
【作者单位】：潍坊医学院附属医院泌尿外科;
【基金】：山东省医药卫生科技发展基金资助项目(2011HW093)
【分类号】：R692.4

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