导尿管外涂氯已定预防尿路感染的临床探讨

Clinical investigation on preventing urinary tract infection by lubricating Chlorhexidine gluconate on the catheter

目的探讨应用2%洗必泰(氯已定)润滑导尿管预防留置尿管相关性尿路感染的作用。方法采用前瞻性、随机对照分析方法,对96例住院留置导尿管患者随机分试验组和对照组,试验组采用2%洗必泰润滑导尿管后按无菌技术操作原则的要求置入导尿管接尿袋密闭式引流;对照组按常规无菌技术操作原则的要求置入导尿管接尿袋密闭式引流,定期留置标本做细菌培养。结果留置导尿管后的第3、7、10天结果显示,对照组细菌培养的阳性率分别为16.67%、37.50%和54.17%,而试验组细菌培养的阳性率分别为分别为2.08%、6.25%和10.42%,对照组细菌培养的阳性率明显高于试验组,两者差异有统计学意义(P<0.05)。结论 2%洗必泰润滑导尿管进行导尿可有效防止细菌通过尿道周围黏膜经尿管管腔外进入膀胱,对预防早期尿路感染是一种有效简便的方法。

Objective To discuss of the application of 2% Chlorhexidine lubricating catheter for prevention of catheter-as sociated urinary tract infection.Methods Ninety six patients with indwelling catheter were randomly divided into experiment group and control group using a prospective,randomized controlled analysis method.Patients in experiment group adopted closed drainage with the catheter lubricated by 2% Chlorhexidine gluconate and urine bag according to the aseptic operation principle;control group placed catheter closed drainage urine bag according to the aseptic operation principle and collected specimen at regular intervals for germiculture.Results The positive rates of bacterial culture 3,7,10 days after the retention catheterization in control group were 16.67%,37.50% and 54.17% respectively;and that of experiment group were 2.08%,6.25% and 10.42% respectively.The positive rate of bacterial culture of control group was higher than that of experiment group,and the difference between the two groups was statistically significant（P 〈0.05）.Conclusion Lubricating catheter by 2% Chorhexidine for catheterization can effectively prevent the bacteria from getting through the urethra surrounding mucosa and into the bladder by the outside of ureter,and it is an effective and simple method to prevent early urinary tract infection.