妇科患者术后不同留置尿管时间尿路感染的临床分析

Clinical analysis of relationship between catheter indwelling

目的探讨不同的留置尿管放置时间与患者尿路感染间的关系,为尿路感染的防治提供指导。方法选取2012年4月-2013年5月妇科手术后实施留置尿管的患者90例,各30例患者分别在留置尿管后1、2、3d拔除尿管,拔除当日采集尿标本,检测细菌及白细胞数量,与正常指标进行对比研究。结果共分离病原菌50株,其中革兰阴性菌33株占66.0%,以大肠埃希菌为主;革兰阳性菌17株占34.0%,以金黄色葡萄球菌为主;1d后拔除留置尿管的有4例患者发生感染,感染率13.33%,2d后拔除留置尿管的有8例患者发生感染,感染率26.67%,3d后拔除留置尿管的有16例患者发生感染,感染率53.33%,总感染率为31.11%,可见感染率随着留置尿管拔除时间增长而升高,差异有统计学意义(χ2=10.221,P<0.05)。结论尿路感染率随着留置尿管时间变长而升高,缩短留置尿管时间可降低尿路感染率。

OBJECTIVE To explore the relationship between the catheter indwelling time and the urinary tract infections so as to provide guidance for prevention and treatment of urinary tract infections. METHODS From Apr 2012 to May 2013, a total of 90 patients who underwent urinary catheter indwelling after gynecological surgery were enrolled in the study, then the catheters of 30 patients in each group were removed at 1, 2, and 3 days after the catheter indwelling, the urine specimens were collected on the extubation day, the bacterial counts and white blood cell counts were detected and compared with the normal levels of indicators. RESULTS A total of 50 strains of pathogens have been isolated, including 33 （66.0%） strains of gram-negative bacteria and 17 （34.0%） strains of grampositive bacteria; the Escherichia coli was the predominant species of gram-negative bacteria; the Staphylococcus aureus was dominant among the gram-positive bacteria. The infections occurred in ; cases at the first day of extu- bation, with the infection rate of 13.33%; the infections occurred in 8 cases at the second day of extubation, with the infection rate of 26.67% ; the infections occurred in 16 cases at the third day of extubation, with the infection rate of 53.33% ; the total infection rate was 31.11% ; the study concluded that the infection rate was increased with the prolonged time of extubation, and the difference was significant （x^2= 10. 221,P^0.05）. CONCLUSION The incidence of urinary tract infections is increased with the prolonged time of extubation to shorten the catheter indwelling time can reduce the incidence of urinary tract infections.