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目的:虽然前列腺穿刺活检术前预防及术后治疗都有了很大的创新,但术后的并发症仍可能发生,本文通过对前列腺穿刺术后感染性并发症的前瞻性检测,对其致病菌进行描述,探讨经直肠前列腺穿刺活检术后败血症的发生率、致病菌、发病相关因素,为临床上败血症的治疗和预防提供理论依据。方法:对2008年1月-2012年11月在兰州军区总医院经直肠前列腺穿刺活检术后238例患者中6例尿路败血症患者进行回顾性分析及术后随访。结果:经直肠前列腺穿刺活检术后并发败血症占2.52%(6/238),8例败血症患者中感染性休克患者3例。血培养阳性6例,5例为大肠埃希菌,1例为耐甲氧西林金葡菌。结论:经直肠前列腺穿刺是简单有效的活检方式,但仍有发生败血症的可能,致病菌多为大肠埃希菌。术前适当准备及术后合理预防可减少并发症的发生。如患者前列腺穿刺活检术后48 h内出现败血症的症状,则应立即入院给予碳青霉烯类治疗。多重耐药大肠埃希菌感染要引起足够重视,早期的直肠及尿液耐药大肠埃希菌检查可有助于败血症的早期预防。
OBJECTIVE: Although there are great innovations in preoperative prevention and postoperative treatment of prostate biopsy, postoperative complications may still occur. By prospective testing of infectious complications after prostatic puncture, Pathogenic bacteria, pathogenesis-related factors, to provide a theoretical basis for the treatment and prevention of clinical sepsis. Methods: Six cases of urinary tract sepsis in 238 patients after transrectal prostate biopsy from January 2008 to November 2012 in Lanzhou Military Region General Hospital were retrospectively analyzed and followed up. Results: Complications of septicemia were 2.52% (6/238) after transrectal prostate biopsy and 3 cases of septic shock in 8 sepsis patients. Blood culture positive in 6 cases, 5 cases of Escherichia coli, 1 case of methicillin-resistant Staphylococcus aureus. Conclusion: Transrectal prostate biopsy is a simple and effective biopsy method, but there is still the possibility of sepsis, most of the pathogens are Escherichia coli. Appropriate preoperative preparation and reasonable prevention can reduce the incidence of complications. Such as patients with prostate biopsy within 48 h after the onset of sepsis symptoms should be immediately given carbapenem treatment. Multi-drug-resistant Escherichia coli infection should pay enough attention to early rectal and urine-resistant Escherichia coli test can help early prevention of sepsis.