留置导尿管伴随性感染危险因素的病例对照分析

Case-control Study of Risk Factors of Catheter-associated Urinary Tract Infection

目的通过回顾性病例对照研究,了解留置导尿管伴随性感染的危险因素,为制定留置导尿管伴随性感染的风险预测表提供数据支持。方法以上海市某三级甲等综合医院2013年1—12月被诊断为留置导尿管伴随性感染的73例患者作为病例组,以1:2配比进行病例对照研究,进行单因素t检验、卡方检验、多因素条件Logistic回归分析,探索研究可能的留置导尿管伴随性感染的危险因素。结果单因素分析共筛选出13个与留置导尿管伴随性感染有统计学意义的因素(P<0.05),经多因素条件Logistic回归分析发现导尿管留管时间、意识障碍、尿路支架置入、使用抗菌药物4项因素与留置导尿管伴随性感染的发生密切相关(P<0.05)。结论留置导尿管伴随性感染的危险因素主要有:导尿管留管时间、意识障碍、尿路支架置入、使用抗菌药物4项,针对上述危险因素,护理中应关注意识障碍、尿路支架置入患者,建立预防感染的评估,并提倡合理用药,结合医护力量力争缩短导尿管留置时间,降低留置导尿管伴随性感染的感染率。

Objective To analyze the risk factors of catheter-associated urinary tract infections through the retrospective case-control study and to provide data support for prediction scale of catheter-associated urinary tract infection. Methods Case group included 73 cases diagnosed with catheter-associated urinary tract infections in a comprehensive hospital throughout 2013, and casecontrol study was performed in the ratio of 1：2. T test, Chi-square test and Logistic regression were used to explore potential risk factors of catheter-associated urinary tract infections. Results In single factor analysis, 13 risk factors pertinent to the catheterassociated urinary tract infections were selected（P 0.05） and in multiple logistic regression analysis, 4 risk factors including indwelling time, disturbance of consciousness, ureteral stent, antibiotics were selected（ P0.05）, and four factors were closely related to the occurrence of the infection. Conclusion Indwelling time, disturbance of consciousness, ureteral stent, antibiotics are four risk factors for catheter-associated urinary tract infections, consequently, effective nursing measures such as the strengthening of infection prevention evaluation, promotion of rational drug use, and shortening the indwelling time should be taken to reduce catheter-associated urinary tract infection rate.