经直肠前列腺穿刺活检术后引起急性前列腺炎原因临床研究.docVIP

经直肠前列腺穿刺活检术后引起急性前列腺炎原因临床研究 　　【摘 要】 目的:研究经直肠前列腺穿刺活检术后引起急性前列腺炎的发病率、临床表现、致病菌和危险因素，并探讨有效的预防措施。方法：总结过去6年内在我院有病历记录的923名行经直肠前列腺穿刺活检术的患者，所有行前列腺穿刺活检的病人均为我院住院病人，所有患者穿刺前均使用环丙沙星注射液预防感染；术后观察记录患者在前列腺穿刺活检后发生急性前列腺炎的发病率、临床表现、致病菌及潜在的危险因素。结果：18名（2.0%）患者在行前列腺穿刺活检后发生急性前列腺炎，其中11名（1.2%）患者出现脓毒血症；术后引起急性前列腺炎的众多危险因素中，术前未清洁灌肠(P=0.01)和既往有过脑血管意外(P=0.048)的患者发病率显著性高于其他患者。结论：喹诺酮类抗生素能够有效地预防大多数经直肠前列腺穿刺活检术后引起的急性前列腺炎；术后发生急性前列腺炎的发病率约为2%，且绝大部分为对氟喹诺酮类抗生素耐药的大肠杆菌引起，术前清洁灌肠是有效的预防措施。 　　【关键词】 活检； 前列腺； 急性前列腺炎 　　 　　Acute prostatitis caused by transrectal prostate biopsy 　　LI Yanmin1, JIANG Hui2, TANG Wenhao2, SONG Leming1, HONG Kai2 　　1 Urology Department, Ganzhou People’s Hospital, Jiangxi Ganzhou, 341000, China 　　2 Urology Department, The Third Hospital of Peking University, BeiJing, 100191, China 　　【Abstract】 Objectives: To investigate the risks, occurrences, clinical manifestation of acute prostatitis after transrectal prostate biopsy, and to find effective prophylactic methods. Methods: We reviewed the medical records of 923 patients receiving transrectal prostate biopsy from March 2005 to June 2010 in our hospital. All biopsies were performed for inpatients. Anciprofloxacin was administered as an antibiotic prophylaxis. The incidence, clinical features, pathogenic bacteria, and potential risk factors associated with acute prostatitis after prostate biopsy were evaluated. Results: Acute prostatitis developed in 18(2.0%) cases after prostate biopsy. Among them, 11(1.2%) showed clinical features of Pyemia. As to the risk factors for acute protatitis after prostate biopsy, the patients were significantly easier to be infected who didn’t receive enema cleansing before biopsy (P=0.01) and who reported past history of cerebrovascular disease (P=0.048). Conculsions: Fluoroquinolong is an effective antibiotic prophylaxis for prostatitis after transrectal prostate biopsy in most cases. The incidence rate of acute prostatitis afrer transrectal prostate biopsy was 2.0%, almost all cases being caused by fluoroq