膀胱肿瘤术后膀胱灌注化疗患者尿路感染的危险因素分析

Analysis of risk factor of patients with urinary bladder irrigation chemotherapy combined with urinary tract infection after bladder tumor resection

目的调查膀胱肿瘤术后行膀胱灌注化疗患者尿路感染的危险因素,为制定有效的预防措施提供科学依据。方法对2010年1月-2012年12月在泌尿外科手术后接受膀胱灌注化疗的92例患者,采用回顾性方法分别统计患者的年龄、性别、有无合并症、灌注次数、留置导尿及细菌培养结果等,采用SPSS13.0进行统计。结果 92例患者中有31例确诊为尿路感染,感染率33.7%,共分离病原菌38株,其中革兰阴性菌27株,占71.1%;主要危险因素包括灌注>6次、年龄≥65岁、留置导尿管、有前列腺增生及糖尿病等基础疾病。结论术前应对前列腺增生糖尿病等基础疾病加以治疗,严格无菌操作和医务人员手卫生,严格控制留置导尿管的适用指征,定期对灌注室及病房的消毒,有助于减少膀胱灌注化疗合并尿路感染的发生率。

OBJECTIVE To investigate the risk factor of patients with urinary bladder irrigation chemotherapy com‐bined with urinary tract infection after bladder tumor resection and to provide scientific basis for formulating effec‐tive preventive measures .METHODS From Jan .2010 to Dec .2010 ,a total of 92 cases of patients received urinary bladder irrigation chemotherapy after urological surgical procedures .Retrospective method was used to record the patient′s age ,genders ,presence of complications ,time of irrigation ,indwelling catheter ,bacterial culture re‐sults ,etc ,respectively .RESULTS There were 31 cases of urinary tract infections in 92 cases ,the total infection rate was 33 .7% ,a total of 38 strains of pathogenic bacteria were isolated ,including 27 strains of gram‐negative bacilli ,accounting for 71 .1% .The main risk factors included more than 6 times of irrigation ,over 65 years of age ,patients with indwelling urinary catheters and having basic diseases such as benign prostate hyperplasia and diabetes .CONCLUSION Preoperative treatment of basic diseases such as hyperplasia of prostate or diabetes ,strict aseptic operation and hand hygiene of medical staff ,strict control of indications of indwelling catheter ,regular dis‐infection of perfusion chamber and ward ,fresh indoor air ,and personal hygiene can help to reduce the incidence of urinary infection after urinary bladder irrigation chemotherapy .