老年患者腔内介入治疗围术期留置尿管泌尿道感染的临床研究

Clinical study of catheter-associated urinary tract infections in elderly patients during perioperative period of endovascular interventional surgery

目的探讨血管外科老年患者腔内介入治疗围术期留置尿管导致泌尿道感染的危险因素并提出预防措施,以降低泌尿道感染发生率。方法对2010年1月-2013年12月血管外科行腔内介入治疗98例老年患者随机分为24、48、72h组,分别为32、33、33例,对留置尿管致泌尿道感染的危险因素进行统计分析。结果术后24h组有1例发生泌尿道感染,感染率为3.1%,术后48h组有3例发生泌尿道感染,感染率为9.1%,术后≥72h组有5例发生,感染率为15.2%,3组比较差异有统计学意义(P<0.05);最常见的病原菌是大肠埃希菌、粪肠球菌和真菌等。结论缩短尿管留置时间可有效降低围术期老年患者泌尿道感染的发生。

OBJECTIVE To explore the risk factors for catheter‐associated urinary tract infections in elderly patients of vascular surgery department during perioperative period of endovascular interventional surgery and put forward the prevention measures so as to reduce the incidence of urinary tract infections .METHODS A total of 98 elderly patients who underwent the endovascular interventional surgery in the vascular surgery department from Jan 2010 to Dec 2012 were enrolled in the study and were randomly divided into the 24‐hour group with 32 cases ,48‐hour group with 33 cases ,and the 72‐hour group with 33 cases ;the risk factors for the catheter‐associated urinary tract infections were statistically analyzed .RESULTS The urinary tract infections occurred in 1 case in the 24‐hour group ,with the infection rate of 3 .1% ;the urinary tract infections occurred in 3 cases in the 48‐hour group ,with the infection rate of 9 .1% ;the urinary tract infections occurred in 5 cases in the no less than 72‐hour group ,with the infection rate of 15 .2% ,there was significant difference among the three groups （P〈0 .05） .The Escherichia coli ,Enterococcus f aecalis ,and fungi were the most common pathogens .CONCLUSION It is an effective way to shorten the urinary catheter indwelling time so as to reduce the incidence of urinary tract infections in the elderly patients during the perioperative period .