导尿管相关尿路感染的易发因素及预防的研究

A Study of the Liable Episode Agent of the Urinary Tract Infection with Association of Cauheter and its Prevention

目的:研究导尿管相关的尿路感染的易发因素,提出预防措施。方法:对108例患者在导尿前均行尿培养证实无尿路感染。108例随机分为A和B两组。A组包括A1组和A2组,A1组(24例)更换引流袋1次/d,A2组(30例)更换引流袋1次/3d。B组包括B1组和B2组。B1组(23例)接受膀胱冲洗2次/d。B2组(31例)不行膀胱冲洗。全部病例均于导尿后第4天和第7天进行尿液细菌培养。结果:更换引流袋的时间和患者的菌尿明显相关,每3d更换引流袋的菌尿发生率低于每天更换者(χ2=6.89,P<0.01);膀胱冲洗组菌尿的发生率高于不冲洗组,差异有显著性(χ2=4.58,P<0.05);留置尿管的时间越久,菌尿的发生率越高(χ2=7.99,P<0.01)。结论:导尿后不膀胱冲洗,引流袋更换2次/周,缩短尿管留置时间等能降低尿路感染率。

Objective To investigate the liable episode agent of the urinary tract infection with relation of catheter and propose the prevention. Methods 108 Cases of patient were not urinary tract infection by urine cultiration before catheterization. 108 Cases were randomly divided into two groups A and B, The group A included group A1 and group A2, The group A1 （24 cases） received to change the drainage bag once each day, The group A2 （30 cases） received to change the drainage bag once three days. The group B included group B1 and group B2. The group B1 （23 cases） received the bladder washing twice each day. but group B2 （31 cases） didn＇t received the bladder washing. All of 108 cases perfomed urine cultivation after catheterization the fourth day and seventh day respectively. Results Between the time of change drainage bag and Patient ＇ s bacteria urine were relativitu. In the group A2 the frequency of the bacteria urine was lower than the group A1 （χ^2 =6. 89,P 〈0.01 ） ; In the group B1 （ bladder washing group ） the frequency of the bacteria urine was higher than the group B2 （ without bladder washing）, there were significance difference （χ^2 = 4. 58, P 〈 0.05 ） ;The time of catheter stay were more long, the frequency of the bacteria urine were more high（χ^2 = 7. 99 ,P 〈 0.01 ）. Conclusion After catheterization don＇t receive bladder washing, to change the drainage bag twice a week, to shorten the time of the catheter stay, these factor can decrease the frequency of the urinarg tract infection. It is significant .