老年患者永久性膀胱造瘘集尿袋更换时间与尿路感染相关性研究

The study for the correlation and intervention between urinary tract infection and urine collection bags changing time aged for patients with permanent cystostomy

目的探讨永久性膀胱造瘘集尿袋更换时间与尿路感染的相关性。方法将80例患者随机分成A、B、C、D四组,每组20例,各组集尿袋更换间隔时间分别为3d、5d、7d、10d,分析比较不同更换时间对尿液细菌检出率的影响;研究患者引流系统不同部位细菌检出情况,分析比较是否存在关联;对患者认知、心理、行为给予护理干预。结果 A、B、C各组间尿液细菌检出率经χ2检验差异无显著意义(P>0.05),而D组与A、B、C三组间检出率差异有显著意义(P<0.05);引起感染的细菌以大肠埃希菌为主,感染源来源于尿袋下端、尿管与尿袋接口处及其他途径;实施护理干预后并发症减少。结论永久性膀胱造瘘集尿袋以每周更换1次为宜;尿路感染的因素有护理不当导致细菌上行感染及医源性因素;恰当的护理干预可提高患者的生活质量。

Objective To study the correlation between urinary tract infection and urine collection bags changing time aged for patients with permanent cystostomy,and to find out the major course of infection and the suitable time to change the urine collecting bag and to provide nursing interventio Method Eighty patients were randomly divided into A,B,C,D group（20 in each group）.Changing time of urine bag were every four days,six days,eight days,eleven days.To study the bacteria detection rate and correlation in urine and several place in drainage system.Nursing intervention was provided for patients＇cognitive,mentality and behavior.Result There were no significant difference in A,B,C group（P0.05）.But there were significant difference between D and other groups（P0.05）.Most infection bacteria were Escherichia coli.Infection bacteria mostly come from the bottom of urine bag and the interface between catheter and urine bag.Conclusion The best time to change urine bag after permanent cystostomy are every week.Infection factor include ascending urinary tract infection and iatrogenic factor.Appropriate nursing intervention could improve the quality of patient life.