脊髓损伤患者康复期尿路感染的危险因素

The clinical study of risk factors affecting urinary tract infection in the patients with spinal cord injury in rehabilitation period

目的:进一步明确影响脊髓损伤(SCI)患者康复期尿路感染(UTI)发生的危险因素。方法:收集我科2003年5月至2008年11月住院的脊髓损伤患者190例,筛选出140例患者进行回顾性分析,选择11个可能对患者尿路感染发生有关的因素,分别进行分组,比较各组的尿路感染率,单因素分析确定影响尿路感染发生的危险因素,多因素Logistic回归分析确定影响其发生的独立危险因素。结果:140例患者总的尿路感染率为44.29%,单因素分析表明:脊髓损伤程度、尿管留置时间、尿管冲洗频率、膀胱区理疗、康复介入时间、尿路感染前抗生素使用和使用时间,以及有无低蛋白血症是影响脊髓损伤住院患者康复期尿路感染的危险因素。多因素Logistic回归分析表明:脊髓损伤程度(P=0.001)、尿管留置时间(P<0.05)是影响脊髓损伤住院患者康复期尿路感染发生的独立危险因素。结论:脊髓损伤患者尿路感染的发生与多个危险因素有关。损伤程度、尿管留置时间是影响其发生的独立危险因素。

Objective：To further research and clearly understand the risk factors that affecting urinary tract infection（UTI） in the patients with spinal cord injury（SCI） in rehabilitation period.Method：A total of 190 clinical cases were collected from the hospitalized patients with SCI from May 2003 to November 2008 in rehabilitation medicine wards in First Clinical College of Guangxi Medical University,in which 140 cases were screened and analyzed retrospectively.Eleven factors that might affect the incidence of UTI in the patients with SCI in rehabilitation period were chosen and grouped separately.The rates of UTI were compared respectively,single factor analysis was used to determine the risk factors affecting the incidence of UTI,multifactor logistic regression analysis was used to determine the independent risk factors affecting its occurrence.Result：The total incidence rate of UTI in 140 cases was 44.29%.Single-factor analysis showed that the degree of SCI,catheter indwelling time,the frequency of catheter flushing,bladder district physiotherapy,rehabilitation intervention time,previous use of antibiotics,the time of using antibiotics and hypoproteinemia were risk factors affecting UTI in the patients with SCI in rehabilitation period.Multi-factor logistic regression analysis showed that the degree of SCI（P =0.001）,catheter indwelling time（P〈0.05） were the independent risk factors affecting its incidence in the hospitalized patients with SCI in rehabilitation period.Conclusion：A number of risk factors affected the incidence of UTI in the hospitalized patients with SCI in rehabilitation period.The degree of SCI and catheter indwelling time were the independent risk factors affecting its incidence in the hospitalized patients with SCI in rehabilitation period.