尿路感染的最新诊治进展.pptVIP

其他预防方法 有人认为多饮水能在细菌粘附和侵入尿路上皮以前清除细菌,这种想法很有吸引力,但是事实上不是这样的。有学者在研究了18～30岁复发性ＵＴＩ患者229例及对照组253例资料后发现,二者排尿习惯和饮水量差异无统计学意义。 有报道规律饮用酸果蔓汁(ｃｒａｎｂｅｒｒｙｊｕｉｃｅ)有降低细菌粘附的作用,但也有持有反对结论者。 有研究表明,乳酸菌通过竞争粘附受体和营养物,形成过氧化氢、乳酸等预防ＵＴＩ。但是,阴道乳酸菌的种类不一样,正常妇女的乳酸菌更多的是产生过氧化氢,而ＵＴＩ患者则不是这样。所以,每天吃乳酸菌产物并不能防止ＵＴＩ。近来研究表明,阴道内放置乳酸菌有效其结论有待进一步证实。到目前为止,还没有可靠的酸性物质能够有效预防复发性ＵＴＩ。 * Authors conclusions There is some evidence that cranberry juice may decrease the number of symptomatic UTIs over a 12 month period, particularly for women with recurrent UTIs. Its effectiveness for other groups is less certain. The large number of dropouts/withdrawals indicates that cranberry juice may not be acceptable over long periods of time. It is not clear what is the optimum dosage or method of administration (e.g. juice, tablets or capsules). Further properly designed studies with relevant outcomes are needed. Summary Cranberries for preventing urinary tract infections Cranberries (usually as cranberry juice) have been used to try and prevent urinary tract infections (UTIs). Cranberries contain a substance that can prevent bacteria from sticking on the walls of the bladder. This may help prevent bladder and other urinary tract infections. This review identified 10 studies (1049 participants) comparing cranberry products with placebo, juice or water. There was some evidence to show that cranberries (juice and capsules) can prevent recurrent infections in women. However, the evidence for elderly men and women was less clear, and there is evidence that is not effective in people who need catheterisation. Many people in the trials stopped drinking the juice, suggesting it may not be a popular intervention. In addition it is not clear how long cranberry juice needs to be taken to be effective or what the required dose might be. * 其他预防方法 雌激素能够降低老年妇女ＵＴＩ的发生率。阴道黏膜雌激素化可以促进乳酸杆菌繁殖,减少泌尿系病菌的存在,降低ＵＴＩ的危险性。一项双盲研究表明在50～70岁的妇女使用雌激素霜后ＵＴＩ明显下降(安慰剂组5.9次感染/患者年,雌激素组0.5次感染/患者年)。 其他正在研究的预防措施有:①无毒Ｅ.ｃｏｌｉ注射到妇女的膀胱内,