成年糖尿病患者细菌性尿路感染的治疗

尿路感染是最常见的细菌感染之一，单纯性尿路感染多发生于健康的成年女性且易于治疗，并发性尿路感染则难以治疗且容易复发。糖尿病是可能并发尿路感染的重要因素之一。本文简单介绍了成年糖尿病患者有症状和无症状型尿路感染在流行病学、发病机制和临床表现方面的特殊性。重点介绍了对糖尿病尿路感染病人的治疗和预防策略，包括抗生素疗法、非抗生素疗法及预防措施。     

女性复发性尿路感染发病机制研究现状

女性尿路感染是常见的细菌感染性疾病，且易复发。其发病受多因素影响，目前对其发病机制尚有争议，本文综述有关复发性尿路感染的发病机制，以便更好地预防和治疗。     

TVT吊带术治疗女性压力性尿失禁8例

目的探讨经阴道无张力尿道中段悬吊（TVT）治疗女性压力性尿失禁的疗效及并发症的预防。方法回顾性总结8例女性压力性尿失禁患者经TVT术治疗的临床资料。结果 8例患者均取得满意疗效,随访2-14个月无复发,无排尿困难及尿路感染等。结论 TVT是治疗女性压力性尿失禁的一种快捷、简便而有效的方法。     

老年女性糖尿病合并尿路感染危险因素分析及对策

目的 探讨老年女性糖尿病(DM)患者尿路感染的状况和危险因素,采取针对性的预防和措施.方法 对老年女性DM患者尿路感染危险因素进行回顾性调查和分析.结果 老年DM并发尿路感染与性别、年龄、病程、血糖控制情况及侵入性操作呈正相关;主要致病菌为革兰阴性菌,其中以大肠埃希菌最为常见,占60.60%.结论 老年女性DM患者尿路感染率高,应予以重视.应积极控制原发病,加强泌尿系统的保护,特别注意具有侵入性插管的护理,是预防老年女性DM尿路感染的重要措施.     

老年科患者尿路感染的易感因素及护理

目的:探讨老年患者尿路感染的因素,总结相应的护理方法及注意事项。方法:选取2010年5月至2011年3月我院老年科住院患者286例,分析和总结患者发生尿路感染的因素。结果:导尿、高龄、女性、长期卧床、合并糖尿病、抗菌药使用不合理、医源性操作不当是老年科患者发生尿路感染的主要易感因素。结论:老年科患者发生尿路感染的因素多,采取正确措施有利于预防和减少尿路感染的发生。     

怎样预防蜜月尿路感染

[问]我是女性,以前得 过尿路感染,最近我要结婚 了,听说,新婚女性容易发生 尿路感染,我该如何预防? 河北 祁××[答]女性的尿道口就在     

雌三醇辅助治疗老年女性复发性下尿路感染

目的　研究老年女性下尿路感染的诱因 ,探讨防治复发的方法 ,提高治愈率。方法　绝经后期复发性下尿路感染患者 12 2例 ,随机分为两组。治疗组采用雌三醇栓联合抗生素 ,对照组则单用抗生素治疗。观察其临床治愈后的复发情况。结果　两组治愈后 3个月及 6个月的复发率分别为 6 45 %、2 8 3 3 % ;4 84%、5 1 66% ,差异显著 (P <0 0 1)。结论　雌三醇辅助抗生素能有效降低老年女性尿路感染的复发率     

女性尿路感染易感因素分析与家庭护理

尿路感染是细菌进入泌尿系统生长繁殖,导致炎症发生的疾病.各种调查资料均显示：在成人中,女性罹患尿路感染明显多于男性.未婚女性发生率为2%,已婚女性发生率为5%,老年女性发生率为100%.本病的致病原因及如何针对各种致病原因进行预防,对女性来说十分重要.现对本病分析报告如下：     

复方乙菧酚药膜防治女性下尿路感染

女性下尿路感染是临床上常见的病症。国内外目前对本症的治疗原则,仍然是在急性期采用短期有效的抗生素治疗。被认为最有实用价值的预防方法是在性交后立即排尿。从1981年开始,我们试制了《复方乙菧酚药膜》预防和治疗女性下尿路感染共18例,效果明显,现予介绍。临床资料:     

新型抗菌液预防留置导尿女性患者尿路感染的疗效观察

目的:观察新型抗菌液(泰术康)在留置导尿女性患者中预防尿路感染的治疗效果。方法:选择197例妇科手术患者,随机分为治疗组和对照组,对照组采用传统方法即0.05%碘伏涂擦尿道口及尿道口外10 cm导尿管,每8小时擦1次;治疗组使用泰术康喷洒尿道口及尿道口外10 cm导尿管,每8小时喷1次,留置后取尿液进行细菌培养,连续两次培养阳性视为尿路感染,比较并分析两组患者采用不同方式治疗后的效果。结果:观察发现治疗后治疗组发生尿路感染5例,对照组发生尿路感染11例,两组数据比较差异具有统计学意义(P<0.05)。结论:用泰术康对留置导尿管的女性患者进行尿道口和尿管表面喷洒,可有效降低尿路感染的发生。     

Female urethral diverticulum containing a calculus: a case report

Urethral diverticula with calculi have a low incidence as reported in the literature. This elderly female patient was first seen with recurrent urinary tract infections (UTIs), dysuria, and hematuria. She had two large stones, one in the bladder and one in a urethral diverticulum. Litholapaxy with a laser was effective in resolving both calculi. Subsequent urethral diverticulectomy was effective in removal of the urethral diverticulum.     

Vesicoureteric reflux and urinary tract infection in children

An association between vesicoureteric reflux (VUR) and renal damage was found in 1960. In 1973, the term reflux nephropathy (RN) was first used to describe the renal damage caused by VUR. Follow up studies show that about 10%-20% of children with RN develop hypertension or end stage renal disease. It is now evident that there is a sex difference in the development of RN. In most males with RN, the kidneys are congenitally abnormal. In females it is an acquired condition, the most severe damage being sustained by recurrent urinary tract infections (UTIs). The purpose of current UTI guidelines is to identify VUR or any other abnormality of the urinary tract. Since the advent of routine antenatal ultrasonography, there is no longer a need to identify an abnormality of the urinary tract after the first reported UTI. Routine investigations are not required. Recurrent UTIs and a family history of VUR need further evaluation. There is also an urgent need to establish the long term value of prophylactic antibiotics in children with VUR.     

Management of urinary tract infections

Urinary tract infections (UTIs) are commonly encountered in medical practice and range from asymptomatic bacteruria to acute pyelonephritis. Enterobacteriaceae with E. coli being the most prevalent, are responsible for most commonly acquired uncomplicated UTIs and usually respond promptly to oral antibiotics. In contradistinction, more resistant pathogens cause nosocomially acquired infections which often require parenteral antibiotic therapy. Patients with acute bacterial prostatitis, usually caused by Enterobacteriaceae present with a tender prostate gland and respond promptly to antibiotic therapy. Chronic bacterial prostatitis on the other hand, is a subacute infection characterized by recurrent episodes of bacterial UTI where the patient presents with vague symptoms of pelvic pain and voiding problems. Treatment is protracted and may be frustrating. Nonbacterial prostatitis and chronic pelvic pain syndrome produce symptoms similar to those of chronic bacterial prostatitis. Treatment is not well defined due to their uncertain etiologies. Most episodes of catheter associated bacteruria are asymptomatic, where less than 5% will be complicated by bacteremia. The use of systemic antibiotics for treatment or prevention of bacteruria is not recommended, particularly in the geriatric age group, since it helps select for resistant organisms. Prevention thus remains the best option to control it. Few patients without catheters who have asymptomatic bacteruria develop serious complications and therefore routine antimicrobial therapy is not justified with only two exceptions : before urologic surgery and during pregnancy.     

The management of childhood urinary tract infections

Urinary tract infections can result in significant morbidity and represent one of the most common urological conditions that the pediatrician and family practitioner encounter in the pediatric patient population. The prevalence of UTI in girls may be as high as 8.1%. UTIs also represent the most commonly identified serious bacterial infection in infants presenting with a febrile illness. Of febrile infants aged 2-3 months, 3-10% have a documented UTI. While the majority of the UTIs are not associated with any significant underlying conditions, the mere presence of a UTI is worrisome to most parents. An appropriate evaluation will determine which of these patients need referral. A brief summary is therefore presented to assist the primary care physician in the evaluation and management of childhood UTIs.     

衡阳地区绝经后妇女泌尿系结石成分分析及代谢评估

本课题旨在探讨衡阳地区绝经后妇女泌尿系结石成分组成及代谢评估,从而针对性地采取预防措施。通过回顾性收集350例绝经后妇女泌尿系结石患者的临床资料。均采用红外光谱分析仪对结石成分分析,结合血生化及24小时尿液成分分析,进行针对性地预防干预。该研究显示绝经后妇女泌尿系结石的化学成分以碳酸磷灰石为主,且多数合并泌尿系感染及代谢异常,可为针对性的采取预防干预措施提供依据。     

Microscopy, culture, and sensitive management of uncomplicated urinary tract infections in adults in the primary care setting

The high prevalence of urinary tract infections (UTIs) places a significant burden on healthcare systems. Clinicians may over-manage the issue, and there is great variability in practice, with economic- and resource- implications. Up to 40% of patients with a suspected UTI do not have an infection. Using PubMed (Medline) to shortlist relevant papers in English from the last 30 years, and further sub-selection to include only uncomplicated UTIs in adults in primary care, we reviewed the literature pertaining to uncomplicated UTIs, and how it should be managed efficiently in the primary care setting. In general practice, there is no advantage to routinely request microscopy and culture of urine samples in the presence of an appropriate history and urinalysis reagent-strip testing. If antibiotics are required, then a 3-day course shall suffice. Larger epidemiological studies focusing on more susceptible sub-populations may provide better guidance for discriminatory factors to produce an algorithm for treatment.     

2010—2012年我院泌尿生殖道支原体感染及耐药性分析

目的 探讨泌尿生殖道感染病人支原体培养情况并分析其耐药性变化,为临床上合理使用抗生素提供参考依据。方法 2010年1月—2012年12月,青岛大学医学院附属医院门诊收治疑为泌尿生殖道支原体感染病人1 236例,对其支原体培养与药敏试验结果进行分析。结果 1 236例中支原体培养阳性316例（25.57%）,其中解脲支原体（Uu）245例（19.82%）,人型支原体（Mh）10例（0.81%）,Uu＋Mh混合感染61例（4.94%）;女性病人Uu和Uu＋Mh阳性率分别为27.05%、6.54%,均显著高于男性的7.46%、2.19%（χ^2=69.79、11.58,P＜0.05）。Uu对氧氟沙星、罗红霉素、司帕沙星耐药率较高,分别为26.53%、17.96%、15.92%;Uu＋Mh只对强力霉素和美满霉素耐药性较低。2011、2012年Uu对抗生素耐药率较2010年有所下降,而Uu＋Mh耐药性有逐渐升高趋势。结论 泌尿生殖道感染支原体培养阳性率女性明显高于男性。支原体对常见抗生素耐药率较高,临床上应行支原体培养＋药敏试验,合理使用抗生素。     

已婚育龄妇女生殖道感染者循证护理干预效果评价

目的了解已婚育龄妇女对生殖道感染有关知识的认知情况,探索循证护理干预对生殖道感染患者的影响。方法对198名社区已婚育龄妇女应用循征护理干预,解决已婚育龄夫妇生殖道感染患者常见的生殖健康问题。结果已婚育龄妇女对生殖保健方面的知识及预防措施知晓率较低;采用循征护理干预前后妇女目标疾病的患病率明显下降。结论循征护理干预是解决已婚育龄妇女生殖道感染患者常见生殖健康问题的有效方法。加强育龄妇女生殖保健服务,通过各种渠道及各种形式开展有关生殖道感染的危害性和防治知识教育,是提高自我保健意识和生殖健康水平的有效措施。     

Prophylaxis of recurrent urinary tract infection in female patients. Efficacy of low-dose, thrice-weekly therapy with trimethoprim-sulfamethoxazole.

Thirty-two women with recurrent urinary tract infections were treated after eradication of existing infections with a mixture of 40 mg of trimethoprim and 200 mg of sulfamethoxazole thrice weekly at bedtime for six months. Six preadolescents received one half this dose. During 21.3 cumulative patient-years of prophylaxis, one infection due to Streptococcus faecalis and one due to a sulfamthoxazole-and trimethoprim-sensitive Escherichia coli occurred--an infection incidence of 0.1 per patient-year. During prophylaxis, 61 of 72 periurethral cultures and 24 of 51 anal canal cultures failed to yield Enterobacteriaceae. One patient had transient colonization with a trimethoprim-resistant E coli during prophylaxis. Twenty-one patients had recurrent infection within six months of discontinuation of prophylaxis, with a mean time to recurrence of 2.6 months. One infection recurred 26 weeks following prophylaxis with a Proteus mirabilis. Thrice-weekly trimethoprim-sulfamethoxazole therapy was effective for prophylaxis of recurrent urinary tract infections and did not predispose to colonization or infection with trimethoprim-resistant Enterobacteriaceae.     

Postcoital antimicrobial prophylaxis for recurrent urinary tract infection. A randomized, double-blind, placebo-controlled trial

We conducted a randomized, double-blind, placebo-controlled study to determine the efficacy of postcoital antibiotic prophylaxis in healthy young women prone to recurrent urinary tract infections. Sixteen patients were randomized to receive postcoital administration of a combination product of trimethoprim and sulfamethoxazole, while 11 received postcoital placebo. The treatment groups were similar with respect to age, parity, diaphragm use, history of lifetime urinary tract infections, frequency of intercourse, and number of lifetime sexual partners. In over 6 months of observation, postcoital administration of trimethoprim-sulfamethoxazole was highly effective in preventing recurrent urinary tract infections. Nine of 11 patients who took the placebo developed urinary tract infections (infection rate, 3.6 per patient-year), compared with only two of 16 patients who received postcoital trimethoprim-sulfamethoxazole (infection rate, 0.3 per patient-year). Postcoital administration of trimethoprim-sulfamethoxazole was effective in patients with both low (two or fewer times per week) and high (three or more times per week) intercourse frequencies. Side effects were few and compliance was excellent. We conclude that postcoital trimethoprim-sulfamethoxazole is a safe, effective, and inexpensive approach to management of recurrent urinary tract infections in young women.