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尿路感染诊断及治疗的十大常见误区(下篇)

2016-08-05 sunshine 译 MedSci原创

误区7:导尿管尿液样本中出现细菌应诊断为UTI。 真相7:事实上,100%的患者放置深Foley导尿管两周会有2-5种微生物定植。导尿管菌落计数可诊断为菌尿,但是必须在出现了临床症状时才可诊断为UTI。 a. 长期放置导尿管的患者中,98%的患者存在菌尿,77%为多种细菌定植。菌尿出现与新的微生物定植之间的平均时间间隔为1.8周。 b. 长期留置导尿管的患者出现菌尿和脓尿后,若要

纯干货!尿路感染诊断及治疗的十大常见误区(上篇)误区7:导尿管尿液样本中出现细菌——诊断为UTI。 真相7:事实上,100%的患者放置深Foley导尿管两周会有2-5种微生物定植。导尿管菌落计数可诊断为菌尿,但是必须在出现了临床症状时才可诊断为UTI。 a. 长期放置导尿管的患者中,98%的患者存在菌尿,77%为多种细菌定植。菌尿出现与新的微生物定植之间的平均时间间隔为1.8周。 b. 长期留置导尿管的患者出现菌尿和脓尿后,若要治疗除非患者出现了感染症状(如发烧、白细胞增多、耻骨上疼痛和压痛,通常不会评估排尿困难)。菌尿和脓尿并不是抗菌治疗的适应症。 c. 虽然抗生素可推迟长期留置导尿管的患者菌尿的发生,但是抗菌治疗最终是用来对抗微生物的。对于长期留置导尿管的患者并不推荐预防感染性用药,但是某些患者可短期(通常小于两周)用药以推迟菌尿的发生,其预防性用药的益处可能大于弊处。 误区8:细菌尿可进展为UTI,因此需要治疗 真相8:细菌尿并不一定会进展为UTI,对于无症状患者不应进行抗菌治疗。 a. 未留置导尿管的老人院老年患者细菌尿的患病率女性为25-25%,男性为15-49

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    2016-09-14 青龙偃月

    学习了,赞一个!

    0

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    2016-09-12 1e10c84am36(暂无匿称)

    文章不错

    0

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    2016-09-06 李东泽

    很好,不错,以后会多学习

    0

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    2016-08-10 忠诚向上

    好好学习

    0

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    2016-08-06 忠诚向上

    见解较新

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