前列腺术后膀胱痉挛患者院内感染情况及其影响因素

Nosocomial infection and the influencing factors for postoperative patients with bladder spasm of prostate

目的研究前列腺术后膀胱痉挛患者的院内感染情况及其影响因素。方法分析360例前列腺疾病患者术后发生院内感染的情况以及患者的年龄、手术方式、导尿管留置时间、手术持续时间、原发疾病种类、合并糖尿病情况、合并高血压情况以及术前预防性使用抗菌药物情况等因素。结果入组患者术后院内感染发生率为30.56%。≥65岁(x^2=9.752,P=0.013)、经尿道手术(x^2=10.751,P=0.009)、导尿管留置时间≥7 d(x^2=9.372,P=0.014)、手术持续时间≥60 min(x^2=6.273,P=0.028)、合并糖尿病(x^2=7.852,P=0.023)以及术前未预防性使用抗菌药物(x^2=12.748,P=0.007)的患者感染发生率较高,差异均具有统计学意义。术后发生院内感染与年龄(b=1.783,95%CI:1.618~1.904)、导尿管留置时间(b=1.465,95%CI:1.288~1.593)、手术持续时间(b=1.465,95%CI:1.288~1.593)、合并糖尿病情况(b=1.587,95%CI:1.427~1.652)呈正相关关系;与手术方式(b=-1.273,95%CI:-1.394^-1.183)、术前预防性使用抗菌药物情况(b=-1.234,95%CI:-1.392^-1.178)呈负相关关系。结论高龄、开放手术、手术时间和导尿管留置时间长、合并糖尿病以及未预防性使用抗菌药物是前列腺术后发生院内感染的危险因素。

Objective To study the nosocomial infection and the influencing factors of postoperative patients with bladder spasm of prostate.Methods Total of 360 patients with prostate diseases were collected and some related factors were analyzed,such as postoperative nosocomial infection,age,operation period,indwelling catheter time,operation duration,primary diseases,diabetic complication,hypertension complication and preoperative prophylactic use of antibiotics.Results The rate of postoperative nosocomial infection was 30.56%.The indwelling catheter time was 7 days or more（x^2= 9.372,P = 0.014）,the operation time was 60 minutes or more（x^2= 6.273,P = 0.028）,in the transurethral operation（x^2 = 10.751,P = 0.009）,when the patients were 65 or more（x^2 = 9.752,P = 0.013）,the infection rate was significantly higher than the patients with diabetes（x^2 = 7.852,P = 0.023） and mellitus if no antibiotic was used before the operation（x^2= 12.748,P = 0.007）,all with significant differences.The postoperative nosocomial infection age（b = 1.783,95%CI：1.618-1.904）,catheter indwelling time（b = 1.465,95%CI：1.288-1.593）,duration of surgery（b =1.465,95%CI：1.288-1.593） and the situation of antibiotics（b = 1.587,95%CI：1.427-1.652） were positively correlated with diabetes mellitus,but negatively correlated with preoperative prophylactic usage（b =-1.234,95%CI：- 1.392-- 1.178）.Conclusions When patients with diabetes mellitus are older in the open operation,the operation time and indwelling catheter time are longer,and non-preventive use of antibiotics were the risk factors of nosocomial infection after prostatectomy.