输尿管碎石术围术期抗生素预防术后感染并发症研究进展
摘要
生素预防术后感染并发症展开探讨，首先指出术后感染高危因素众多，术前需综合评估患者感染风险以确定抗生素
应用疗程与剂量；其次强调要结合当地细菌谱及耐药情况谨慎选择敏感抗菌药物；再者针对中段尿细菌培养结果，
分别阐述了尿培养阴性和阳性患者抗生素选择的相关研究及建议，如阴性患者不同结石大小的预防策略、阳性患者
不同预防方案对感染控制的效果等。总之，术前合理应用抗生素预防术后感染意义重大，但部分应用细节仍需更多
研究进一步明确。
关键词
全文:
PDF参考
[1]QI Q. Nomogram for predicting risk factors of fever
in patients with negative preoperative urine culture after
retrograde intrarenal surgery[J]. World Journal of Urology,
2023. DOI:10.1007/s00345-023-04302-5.
[ 2 ] D Y B O W S K I B , B R E S - N I E W A D A E ,
RZESZUTKO M, et al. Risk factors for infectious
complications after retrograde intrarenal surgery - a systematic
review and narrative synthesis[J]. Central European Journal of
Urology, 2021, 74(3): 437-445. DOI:10.5173/ceju.2021.250.
[3]CHUGH S, PIETROPAOLO A, MONTANARI
E, et al. Predictors of Urinary Infections and Urosepsis After
Ureteroscopy for Stone Disease: a Systematic Review from
EAU Section of Urolithiasis (EULIS)[J]. Current Urology
Reports, 2020, 21(4): 16. DOI:10.1007/s11934-020-0969-2.
[4]中华医学会泌尿外科分会，中国泌尿系结石联
盟.软性输尿管镜术中国专家共识[J].中华泌尿外科杂志，
2016，37（8）：561-565. DOI：10.3760/cma.j.issn.1000-
6702.2016.08.001.
[5]王硕，时新宇，王晓甫，等.术前尿培养阴性患者
输尿管软镜碎石术后发热的危险因素分析及预测发热列
线图模型的构建[J].中华泌尿外科杂志，2024，45（03）：
202-207. DOI：10.3760/cma.j.cn112330-20230922-00086.
[6]YANG M, LI Y, HUANG F. A nomogram for
predicting postoperative urosepsis following retrograde
intrarenal surgery in upper urinary calculi patients with
negative preoperative urine culture[J]. Scientific Reports,
2023, 13(1): 2123. DOI:10.1038/s41598-023-29352-y.
[7]SENOCAK C, OZCAN C, SAHIN T, et al. Risk
Factors of Infectious Complications after Flexible Ureterorenoscopy with Laser Lithotripsy[J]. 2018, 15(4): 158-163.
[8]上尿路结石围手术期感染控制及抗菌药物应用
专家意见编写组.上尿路结石患者围手术期感染控制
及抗菌药物应用专家意见（2023版）[J].中华泌尿外科
杂 志，2023，44（07）：481-485. DOI：10.3760/cma.
j.cn112330-20230620-00224.
[9]ZHAO Z, SUN H, ZHU W, et al. A new model
to assist decision-making of optimal antibiotics duration for
treating asymptomatic bacteriuria or pyuria prior to retrograde
intrarenal surgery[J]. Minerva Urology and Nephrology IF4.9,
2021[2023-07-24]. https://www.minervamedica.it/index2.
php?show=R19Y9999N00A21071503. DOI:10.23736/
S2724-6051.21.04454-2.
[10]WANG L, YU X, QIU Z, et al. Influence of
preoperative urine culture and bacterial species on urogenital
sepsis after ureteral flexible lithotripsy in patients with upper
urinary tract stones[J]. Frontiers in Medicine, 2024, 11:
1393734. DOI:10.3389/fmed.2024.1393734.
[11]LI J, JIANG F, XIE A, et al. Analysis of the
Distribution and Drug Resistance of Pathogens in Patients
with Urinary Tract Infection in the Eastern Chongming
Area of Shanghai from 2018 to 2020[J]. Infection and Drug
Resistance, 2022, Volume 15: 6413-6422. DOI:10.2147/
IDR.S384515.
[12]DE LORENZIS E, ALBERTO T, GALLIOLI
A, et al. Bacterial scenario and antibiotic resistance pattern
in patients candidate to endourology for urolithiasis[J].
European Urology Supplements, 2019, 18(7): e2919-e2920.
DOI:10.1016/S1569-9056(19)33086-6.
[13]CAI T, COCCI A, COCCARELLI F, et al.
Infectious Complications After Laser Vaporization of Urinary
Stones During Retrograde Intrarenal Surgery Are Not
Associated with Spreading of Bacteria into Irrigation Fluid but
with Previous Use of Fluoroquinolones[J]. European Urology
Focus, 2021, 7(1): 190-197. DOI:10.1016/j.euf.2019.02.018.
[14]ZISMAN A, BADAAN S, KASTIN A, et al.
Tailoring Antibiotic Prophylaxis for Ureteroscopic Procedures
Based on Local Resistance Profiles May Lead to Reduced
Rates of Infections and Urosepsis[J]. Urologia Internationalis,
2020, 104(1-2): 106-112. DOI:10.1159/000503905.
[15]BAŞ O, TUYGUN C, DEDE O, et al.
Factors affecting complication rates of retrograde flexible
ureterorenoscopy: analysis of 1571 procedures—a singlecenter experience[J]. World Journal of Urology, 2017, 35(5):
819-826. DOI:10.1007/s00345-016-1930-3.
[16]WOLF J S, BENNETT C J, DMOCHOWSKI R
R, et al. Best Practice Policy Statement on Urologic Surgery
Antimicrobial Prophylaxis[J]. Journal of Urology, 2008,
179(4): 1379-1390. DOI:10.1016/j.juro.2008.01.068.
[17]DENG T, LIU B, DUAN X, et al. Antibioticprophylaxis in ureteroscopic lithotripsy: a systematic review
and meta‐analysis of comparative studies[J]. BJU International,
2018, 122(1): 29-39. DOI:10.1111/bju.14101.
[18]ZHAO Z, FAN J, SUN H, et al. Recommended
antibiotic prophylaxis regimen in retrograde intrarenal
surgery: evidence from a randomised controlled trial[J].
BJU International, 2019, 124(3): 496-503. DOI:10.1111/
bju.14832.
[19]ZENG G, TRAXER O, ZHONG W, et al.
International Alliance of Urolithiasis guideline on retrograde
intrarenal surgery[J]. BJU International, 2023, 131(2): 153-
164. DOI:10.1111/bju.15836.
[20]M É N D E Z‐G U E R R E R O D M ,
BUITRAGO‐CARRASCAL C, PUENTES‐BERNAL A F,
et al. Antibiotic prophylaxis in flexible ureterorenoscopy with
negative urine culture[J]. BJUI Compass, 2023, 4(6): 688-
694. DOI:10.1002/bco2.242.
[ 2 1 ] E L - A G A M Y E S I , E L H E L A L Y M A ,
ABOUELGREED T A, et al. Randomized comparison of
effect of standard antibiotic prophylaxis versus enhanced
prophylactic measures on rate of urinary tract infection
after flexible ureteroscopy[J]. Archivio Italiano di Urologia
e Andrologia, 2023[2023-10-15]. https://www.
pagepressjournals.org/index.php/aiua/article/view/11084.
DOI:10.4081/aiua.2023.11084.
[22]GOKALP F, ABAT D, KORAS O, et al. Singledose fosfomycin could prevent infectious complications
after retrograde intrarenal surgery: A prospective study[J].
Progrès en Urologie, 2023, 33(3): 110-117. DOI:10.1016/
j.purol.2022.12.011.
[23]YOO J W, LEE K S, CHUNG B H, et al. Optimal
duration of preoperative antibiotic treatment prior to
ureteroscopic lithotripsy to prevent postoperative systemic
inflammatory response syndrome in patients presenting with
urolithiasis-induced obstructive acute pyelonephritis[J]. 2021,
62(6): 681-689. DOI:10.4111/icu.20210160.
Refbacks
- 当前没有refback。
