PDF(Pubmed)
Abstract：
To assess the effect of co-trimoxazole and N-acetylcysteine (NAC), alone and in combination, on bacterial adherence to biofilm formed on ureteral stent surfaces. This prospective randomized study was conducted on 636 patients who underwent double J ureteral stent insertion after variable urological procedures. Patients were randomized into four groups: A (n = 165), no antibiotics or mucolytics during stent indwelling; B (n = 153), oral NAC (200 mg/day for children aged < 12 years old and 600 mg/day for adults) during stent indwelling; C (n = 162), oral co-trimoxazole (2 mg TMP/kg/day) during stent indwelling; and D (n = 156), both oral NAC and co-trimoxazole during stent indwelling. Two weeks following double J stent (JJ stent) insertion, urinalysis was performed on all patients and urine culture was done for all the patients at the day of double J stent removal. The stent was removed 2 weeks postoperatively, and a stent segment sized 3-5 cm from the bladder segment of the stent was sent for culture. Positive stent cultures were found in 63.6% (105/165), 43.1% (66/153), 37% (60/162), and 19.2% (30/156) patients of groups A, B, C, and D, respectively. E. coli was the organism most commonly isolated from the stent culture in all groups. The combination of co-trimoxazole and NAC was more effective in reducing bacterial adherence on ureteral stent surfaces than either alone.
摘要：
为了评估复方新诺明和N-乙酰半胱氨酸（NAC）的效果，单独和组合，细菌粘附在输尿管支架表面形成的生物膜上。这项前瞻性随机研究是对636例患者进行的，这些患者在泌尿外科手术后接受了双J输尿管支架插入。患者被随机分为四组：A（n=165），支架留置期间无抗生素或粘液溶解剂；B（n=153），支架留置期间口服NAC（12岁以下儿童为200mg/天，成人为600mg/天）；C（n=162），支架留置期间口服复方新诺明（2mgTMP/kg/天）；和D（n=156），支架留置期间口服NAC和复方新诺明。双J支架（JJ支架）插入两周后，对所有患者进行尿液分析,并在双J支架移除当天对所有患者进行尿液培养.术后2周取支架,并且将距支架的膀胱段3-5厘米大小的支架段送去进行培养。支架培养阳性占63.6%(105/165),43.1%(66/153)，37%（60/162），A组19.2%(30/156)的患者，B,C,D,分别。大肠杆菌是所有组中最常见的从支架培养物中分离的生物体。复方新诺明和NAC的组合比单独使用两者更有效地减少输尿管支架表面上的细菌粘附。
