彻底碘伏直肠消毒法预防经直肠超声引导下前列腺穿刺术术后感染

发布时间：2018-06-12 15:48

本文选题：前列腺 + 穿刺　；参考：《实用医学杂志》2017年24期

【摘要】：目的探讨彻底碘伏直肠消毒法预防经直肠超声引导下前列腺穿刺术后感染的疗效。方法回顾性分析了自2014年4月至2017年1月,收治的怀疑前列腺癌行经直肠超声引导下前列腺穿刺术患者520例。所有患者均于术前1 d开始服用聚乙二醇电解质散剂(舒泰清)行肠道准备,保证术前排便为水样清便,并于术前1 d夜间10点开始禁食。自2014年4月至2015年6月,共206例患者(A组)行经直肠前列腺穿刺术,该组患者穿刺前仅行常规直肠消毒,即碘伏消毒直肠3遍。自2015年7月至2017年1月,共有314例患者(B组)行前列腺穿刺术,该组患者穿刺前行彻底直肠消毒,即用碘伏溶液与2%利多卡因溶液5 m L的混合液消毒直肠共20遍。经检验两组患者的平均年龄、平均PSA值和平均前列腺体积差异均无统计学意义。两组患者均使用18G前列腺穿刺针行经直肠超声引导下13针前列腺穿刺术,术后给予硫酸依替米星注射液300 mg每日1次静滴直至术后2 d预防感染治疗。比较两组术后感染率有无差异。结果 A组患者有7例(3.4%)发生感染,而B组患者有0例(0%)发生感染(P=0.004)。表明B组感染率明显比A组低,两组间有统计学差异。结论彻底碘伏直肠消毒法在预防经直肠超声引导下前列腺穿刺术后感染方面是一种安全有效成本低廉的方法。
[Abstract]:Objective to evaluate the efficacy of complete iodophor rectal disinfection (Iodophor rectal disinfection) in the prevention of infection after prostate puncture guided by transrectal ultrasound. Methods 520 patients with suspected prostate cancer undergoing transrectal ultrasound guided prostatic puncture from April 2014 to January 2017 were retrospectively analyzed. All the patients began to take polyethylene glycol electrolyte powder (Sutai Qing) for intestinal preparation at 1 day before operation to ensure that the defecation before operation was clear of water and fasting at 10:00 1 day before operation. From April 2014 to June 2015, 206 patients (group A) underwent transrectal prostatic puncture. From July 2015 to January 2017, a total of 314 patients (group B) underwent prostatic puncture. The patients were sterilized thoroughly before puncture, that is, the rectum was disinfected for 20 times with a mixture of iodophor solution and 2% lidocaine solution (5 mL). There was no significant difference in mean age, PSA and prostate volume between the two groups. The patients in both groups were treated with 18 G prostatic puncture needle under the guidance of transrectal ultrasound. After the operation, 300 mg Etimicin sulfate injection was given intravenously until 2 days after operation to prevent infection. The infection rate was compared between the two groups. Results there were 7 cases of infection in group A and 0 cases in group B). The infection rate in group B was significantly lower than that in group A, and there was statistical difference between the two groups. Conclusion complete iodophor rectal disinfection is a safe, effective and low cost method in preventing infection after prostate puncture guided by transrectal ultrasound.
【作者单位】：北京积水潭医院泌尿外科;
【分类号】：R737.25

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