[关键词]
[摘要]
目的 观察癃清片治疗小儿外生殖器畸形术后尿道感染的临床疗效。方法 109例隐匿阴茎及尿道下裂手术患儿随机分为两组,治疗组49例(隐匿阴茎30例+尿道下裂19例)术后先静脉滴注头孢替唑1~5 d,随后单用癃清片治疗4~7 d;对照组60例(隐匿阴茎32例+尿道下裂28例),单用头孢替唑静脉滴注;隐匿阴茎患儿术后留置硅胶气囊导尿管5 d,尿道下裂患儿术后留置硅胶气囊导尿管8~14 d,两组均至拔除导尿管次日停药;用药期间观察阴茎创面愈合情况,每3天复查尿常规1次,每5~7天复查尿培养1次,拔除导尿管后第2天再次复查尿常规及尿培养各1次。结果 所有患儿术后均无畏寒、发热等全身炎症反应;术后均未发生阴茎创面感染及皮肤坏死;术后治疗组尿道下裂患儿尿培养阳性2例,为鲍曼不动杆菌和大肠埃希氏菌,对照组尿道下裂患儿术后尿培养阳性5例,2例为大肠埃希氏菌,1例为鲍曼不动杆菌,2例表皮葡萄球菌,隐匿阴茎患儿尿培养均未见细菌生长;尿道下裂患儿治疗组发生尿漏2例,对照组尿漏3例。结论 癃清片对术后留置导尿管患儿,可有效预防泌尿道感染的发生,减少术后抗生素的使用时间,临床使用安全,值得临床推广。
[Key word]
[Abstract]
Objective To observe the clinical effect of Longqing Tablets for the treatment of urinary-tract infection after the surgery of pediatric external genitals malformation. Methods A total of 109 pediatric cases of buried penis and hypospadias surgeries were divided into two groups:49 cases of observation group (30 cases of buried penis and 19 cases of hypospadias) and 60 cases of control group (32 cases of buried penis + 28 cases of hypospadias). Ceftezole was intravenous drip given to each group for 1 to 5 d. And then Longqing Tablets was given to the observation group for 4 to 7 d. Indwelling catheter was used for buried penis children for 5 d, and hypospadias children for 8 to 14 d. After that, the injection was stopped at the day after removing the urethral catheter. The wound healing during the medicine treatment was observed. And the urine routine was checked every 3 d. The urine culture was checked every 5 to 7 d. The urine routine and urine culture was checked at day 2 after removing the urethral catheter. Results All the children had no systemic inflammatory symptoms, like chills and fever. None wound infection and skin necrosis happened after the surgery. Two cases positive reactions of urine culture occurred in hypospadias observation group after the surgery (Baumanii and Escherichia coli). And five cases occurred in control group (2 cases of Escherichia coli, 1 case of Baumanii, 2 cases of Staphylococcus epidermidis). Buried penis children of both group were normal in urine culture test. Two cases of urinary leakage accurred in hypospadias in observation group, while three cases in control group. Conclusion Longqing Tablets treatment can effectively prevent the children with indwelling catheter from urinary tract infection after the surgery. It can reduce the use of antibiotics. It's safe and worth promoting in clinical practice.
[中图分类号]
[基金项目]
武汉市卫生计生科研基金资助,武汉市卫生和计划生育委员会临床医学科研面上项目(中医药及中西医结合类WZ17D03)