泌尿系统手术前尿液培养的时间 - - 我们能做得更好吗? - - 一项比较研究
Matan Mekayten1, Eliyahu M Heifetz2, Yishai Sompolinsky3
1Department of Urology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.
Urolithiasis
|August 27, 2023
概括
在手术前90天内进行的尿培养 (UC) (90PreOp UC) 能够比单次手术前UC (PreOP UC) 更好地预测内分泌手术后的术后感染. 这一发现强调了审查最近的尿液培养的重要性,以改善患者的治疗结果.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 传染性疾病 传染性疾病
- 医学诊断 医学诊断 医学诊断
背景情况:
- 泌尿外科手术对于上尿路结石疾病是标准的.
- 感染是常见的并发症,通常通过术前尿液培养 (UC) 进行监测.
- 最近与直接手术前UCs对传染性并发症的预测价值尚未得到充分确立.
研究的目的:
- 在预测术后感染性并发症方面,比较90天前 (90PreOp UC) 阳性尿液培养与单次手术前UC (PreOP UC) 的疗效.
- 评估阳性UCs与术后泌尿和近邻阻塞的阳性培养 (Prox UC) 的相关性.
主要方法:
- 对140名连续接受内泌尿道结石手术的患者进行了回顾性分析.
- 积极的PreOp UC和积极的90PreOp UC在预测术后泌尿和Prox UC的比较.
- 统计分析包括赔率比率 (OR),灵敏度和ROC曲线下的面积 (AUC).
主要成果:
- 积极的90PreOpUCs (22%) 比积极的PreOpUCs (11%) 更频繁.
- 所有六个败血症事件和93.3%的阳性Prox UC病例与阳性90PreOp UC相关.
- 积极的90PreOp UC显示了与PreOp UC (AUC 0.70) 相比,Prox UC (AUC 0.90) 的更高的预测值.
- 使用90PreOp UC (27%),比使用PreOp UC (12%),更好地识别出尿病原体持久性.
结论:
- 在手术前90天内获得的阳性尿液培养与单个手术前尿液培养相比,在内分泌石手术后出现术后感染性并发症的更好预测因素.
- 审查最近的 (90天) 尿液培养结果可以提高感染后果的预测,指导术后管理.
- 这种方法可以提高患者的安全性和泌尿器科结石治疗的结果.
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