苯扎氯铵溶液膀胱冲洗预防留置导尿患者尿路感染的实效性评价

Effectiveness of bladder irrigation with benzalkonium chloride solution in prevention of urinary tract infections in indwelling catheterization patients

目的评价苯扎氯铵溶液膀胱冲洗预防长期留置导尿患者尿路感染的实效性,探讨苯扎氯铵对尿路感染的预防效果。方法选择2013年5月-2014年5月在医院治疗需要长期留置导尿患者76例,按照膀胱冲洗方式的不同将其随机分为A、B组,每组各38例;A组患者采用0.0025%苯扎氯铵溶液进行膀胱冲洗,B组患者采用0.9%生理盐水溶液进行膀胱冲洗,观察并比较两组患者尿路感染情况。结果膀胱冲洗第1周和第2周后A组患者尿液细菌培养阳性率分别为15.79%和21.05%,明显低于B组的52.63%和71.05%,两组比较差异有统计学意义(P<0.05);A组患者尿液中白细胞计数分别为(6.7±3.0)个/HP和(8.7±4.0)个/HP,均低于相应B组的(11.5±4.4)个/HP和(16.7±6.7)个/HP,两组比较差异有统计学意义(P<0.05);A组中段尿中总细菌数少于B组,其各类菌株构成比差异有统计学意义(P<0.05)。结论苯扎氯铵溶液膀胱冲洗在预防长期留置导尿患者下尿路感染方面具有很好的效果,冲洗后细菌阳性率低,值得临床推广应用。

OBJECTIVE To evaluate the effectiveness of bladder irrigation with benzalkonium chloride solution in prevention of lower urinary tract infections in patients undergoing long‐term indwelling catheterization and observe the effect of benzalkonium chloride on prevention of the urinary tract infections .METHODS A total of 76 patients who needed to be treated with long‐term indwelling catheterization from May 2013 to May 2014 were enrolled in the study and randomly divided into the group A and group B according to the approach of bladder irrigation ,with 38 cases in each group .The group A was treated with bladder irrigation with 0 .0025% benzalkonium chloride so‐lution ,while the group B was given the bladder irrigation with 0 .9% normal saline solution .The incidence of uri‐nary tract infection was observed and compared between the two groups of patients .RESULTS The positive rate of bacterial culture of urine was 15 .79% in the group A after the bladder irrigation for one week ,significantly lower than 52 .63% in the group B ;the positive rate of bacterial culture of urine was 21 .05% in the group A after the bladder irrigation for two weeks ,significantly lower than 71 .05% in the group B （P〈0 .05） .The white blood cell counts of urine of the group A were （6 .7 ± 3 .0）/HP after the bladder irrigation for one week ,less than（11 .5 ± 4 .4）/HP of the group B ;the white blood cell counts of urine of the group A were （8 .7 ± 4 .0）/HP after the blad‐der irrigation for two weeks ,less than （16 .7 ± 6 .7）/HP of the group B ,and there was significant difference be‐tween the two groups （P〈0 .05） .The bacterial colony counts of midstream urine of the group A were less than those of the group B ,and there was significant difference in the constituent ratios of various species of pathogens （P〈0 .05） .CONCLUSION The bladder irrigation with benzalkonium chloride solution can achieve significant effect on prevention of lower urinary tract infections in the patients undergoing long‐term indwelling catheterization ,and the positive rate of bacterial culture is low after the irrigation ;it is worthy to be promoted in the hospital .