实用肿瘤杂志2025，Vol.40Issue(6)：553-561,9.DOI:10.13267/j.cnki.syzlzz.2025.079
根治性膀胱切除术后一年尿路感染发生率及其影响因素分析
Analysis of incidence and influencing factors of urinary tract infection one year after radical cystectomy
摘要
Abstract
Objective To investigate the incidence of urinary tract infection(UTI),the distribution of pathogenic bacteria causing UTI,and their influencing factors within one year after radical cystectomy.Methods The clinical data of 431 patients with bladder cancer who underwent radical cystectomy combined with urinary diversion at Yunnan Cancer Hospital(the Third Affiliated Hospital of Kunming Medical University)(n=286),and the Second Affiliated Hospital of Kunming Medical University(n=145)from January 2018 to July 2023 were retrospectively analyzed.The UTI incidence and distribution of pathogenic bacteria 3,6,and 12 months after surgery were analyzed.The influencing factors of UTI 12 months after surgery were analyzed.Results A total of 256 patients had 355 episodes of UTI within 12 months after surgery,with the incidence rates of 45.05%,33.65%,and 35.27%3,6,and 12 months post-surgery,respectively.The inci-dence of UTI 3,6,and 12 months after surgery all showed significant difference among patients receiving different types of urinary diversion methods which were ureterocutaneostomy,orthotopic neobladder,and ileal conduit(all P<0.01).A total of 27 pathogenic bacteria were de-tected within 12 months after surgery,and Escherichia coli was the most common pathogenic bacterium after surgery.Multivariate logistic regression analysis showed that the history of preoperative systemic chemotherapy,surgical operator,urinary diversion mode,postopera-tive urinary incontinence,postoperative urinary retention,postoperative hydronephrosis,and urinary tract obstruction were the influenc-ing factors of postoperative long-term UTI(all P<0.05).Conclusions The incidence of postoperative UTI in patients undergoing radical cystectomy combined with urinary diversion is high,and is different among patients receiving different urinary diversion methods.Esche-richia coli is the most common pathogenic bacterium after surgery.Targeted treatment measures should be given according to the causes of UTI in different urinary diversion modes,and antibiotics should be used rationally for different pathogens to reduce the incidence of postoperative UTI.关键词
膀胱癌/尿路感染/根治性膀胱切除术/尿流改道/影响因素Key words
bladder cancer/urinary tract infection/radical cystectomy/urinary diversion/influencing factors引用本文复制引用
於青梅,石涛,李召怡,张建杰,付玉,王俊..根治性膀胱切除术后一年尿路感染发生率及其影响因素分析[J].实用肿瘤杂志,2025,40(6):553-561,9.基金项目
云南省科技厅昆明医科大学基础研究联合专项项目(202501AY070001-259) （202501AY070001-259）
昆明医科大学研究生创新基金资助项目(2024S032) （2024S032）
