中国组织工程研究 ›› 2018, Vol. 22 ›› Issue (11): 1781-1785.doi: 10.3969/j.issn.2095-4344.0179

• 骨与关节综述 bone and joint review • 上一篇    下一篇

关节置换前无症状菌尿

张庆宇1,高福强2,孙 伟2   

  1. 1北京协和医学院中日友好医院,北京市 100029;2中日友好医院骨科一部,骨坏死与关节保留重建中心,北京市 100029
  • 出版日期:2018-04-18 发布日期:2018-04-18
  • 通讯作者: 孙伟,主任医师,教授,博士生导师,硕士生导师,北京协和医学院中日友好医院骨关节外科,骨坏死与关节保留重建中心,北京市 100029
  • 作者简介:张庆宇,男,1990年生,山东省潍坊市人,汉族,北京协和医学院中日友好临床医学院在读博士,主要从事股骨头坏死、关节置换方面的研究。
  • 基金资助:

    国家自然科学基金面上项目(81372013,81672336)

Asymptomatic bacteriuria before arthroplasty

Zhang Qing-yu1, Gao Fu-qiang2, Sun Wei2   

  1. 1China-Japan Friendship Hospital, Peking Union Medical College, Beijing 100029, China; 2First Department of Orthopedics,Osteonecrosis and Joint Reservation Reconstruction Center, China-Japan Friendship Hospital, Beijing 100029, China
  • Online:2018-04-18 Published:2018-04-18
  • Contact: Sun Wei, Chief physician, Professor, Doctoral supervisor, Master’s supervisor, First Department of Orthopedics, Osteonecrosis and Joint Reservation Reconstruction Center, China-Japan Friendship Hospital, Beijing 100029, China
  • About author:Zhang Qing-yu, Doctoral candidate, China-Japan Friendship Hospital, Peking Union Medical College, Beijing 100029, China
  • Supported by:

    the General Project of National Natural Science Foundation of China, No. 81372013 and 81672336

摘要:

文章快速阅读:

 
 
文题释义:
无症状菌尿:指患者没有任何泌尿系感染的症状和体征,但通过清洁中段尿培养证明存在真性细菌尿,目前最常用的诊断标准是结果大于105菌落形成单位(CFU)/mL。无症状菌尿在临床上非常常见,而且在女性中患病率更高,随着年龄的增加而提高。在学龄期女孩中,无症状菌尿的患病率仅有1%,在超过80岁的健康女性中则超过了20%。
关节置换后泌尿系感染:泌尿系感染被认为是关节置换术后感染的一项危险因素,病原体可以通过血源性或直接播散的形式导致假体周围或术区浅表的感染,影响患者的康复,延长住院时间,甚至给患者带来新一轮的手术打击。
 
摘要
背景:泌尿系感染的血源性播散是导致关节置换术后感染的原因之一,而对于泌尿系感染中的一种特殊情况,即无症状菌尿在关节置换术中的意义目前研究较少。
目的:探究关节置换前无症状菌尿与置换后感染并发症的关系,评价对其进行筛查和治疗能否给患者带来收益。
方法:采用系统回顾的方法,研究者检索了PubMed、Embase、Cochrane Library和中国期刊全文数据库等4个数据库,搜集关于关节置换前无症状菌尿的临床研究,提取文中数据,评价文献质量,并对该问题进行综合的评价和分析。
结果与结论:最终筛选出7篇符合条件的文献,通过总结其内容证明:①关节置换前无症状菌尿的存在与置换后假体周围感染有显著相关性,但两者之间并不是因果关系;②患有置换前无症状菌尿的患者有着较高的浅表术区感染率,但并没有证据表明无症状菌尿是浅表感染的直接来源;③无症状菌尿可以作为预示指标,表明患者在关节置换后容易发生感染;④对置换前无症状菌尿进行治疗不能降低关节置换后各种感染并发症的发生;⑤目前研究并不支持对关节置换前无症状菌尿进行常规筛查和治疗。

中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程
ORCID: 0000-0002-5987-7814(张庆宇)

关键词: 无症状菌尿, 骨科植入物, 人工假体, 关节置换, 国家自然科学基金

Abstract:

BACKGROUND: Hematogenous spread of urinary tract infection is one of the causes of infection after arthroplasty. The significance of a special portion of urinary tract infection, namely asymptomatic bacteriuria in arthroplasty is little reported.

OBJECTIVE: To explore the correlation of preoperative asymptomatic bacteriuria and infection after arthroplasty and evaluate the benefits of screening and treating asymptomatic bacteriuria.
METHODS: The researchers searched PubMed, Embase, the Cochrane Library and CNKI databases to collect the clinical studies on asymptomatic bacteriuria before arthroplasty. Then, data extraction, quality assessment of the literature, and result analysis were conducted.

RESULTS AND CONCLUSION: Finally, seven eligible articles were included. (1) Preoperative asymptomatic bacteriuria is significantly associated with the occurrence of postoperative prosthetic infection, but it is not a causal relationship. (2) Patients with asymptomatic bacteriuria have a high rate of superficial wound infection but no evidence shows that urinary infection is the direct source of contamination. (3) Asymptomatic bacteriuria is an indicator of increased susceptibility to infection after arthroplasty. (4) Treating asymptomatic bacteriuria before arthroplasty cannot decrease the incidence of various postoperative infectious complications. (5) Current clinical evidence does not support the routine screening and treatment of asymptomatic bacteriuria before arthroplasty.

中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程

Key words: Arthroplasty, Replacement, Prosthesis Implantation, Bacteriuria, Tissue Engineering

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