导尿管腹部固定法对脑卒中患者泌尿系感染及舒适度的影响

Influence of abdominal fixation approach of indwelling catheter on urinary tract infections and comfort degree of stroke patients

目的探讨导尿管腹部固定法对脑卒中患者泌尿系感染及舒适度的影响,为脑卒中患者留置导尿管提供参考。方法选择2014年1月-2015年6月100例需要留置尿管的脑卒中患者为研究对象,采用随机数字表法分为观察组与对照组各50例,观察组导尿管给予腹部固定法,对照组患者给予大腿内侧固定法,导尿管分别给予腹部固定法与大腿内侧固定法;观察1周,比较两组患者脑卒中相关感染等发生情况,并分析两组患者舒适度差异。结果观察组泌尿系感染率为4.0%,明显低于对照组的16.0%,差异有统计学意义(P<0.05);观察组尿管引流不畅、出现皮肤压痕、导尿管变形情况发生率分别为4.0%、24.0%、8.0%,均明显低于对照组的16.0%、80.0%、30.0%,差异有统计学意义(P<0.05);观察组翻身困难、会阴护理困难、观察困难及感觉不适发生率分别为8.0%、2.0%、2.0%、4.0%,明显低于对照组的30.0%、16.0%、30.0%、16.0%,差异有统计学意义(P<0.05);观察组Ⅰ、Ⅱ、Ⅲ度疼痛构成比分别为20.0%、4.0%、1.0%,低于对照组的48.0%、16.0%、8.0%,且观察组疼痛评分(3.33±0.52)分亦低于对照组(5.32±0.69)分,差异有统计学意义(P<0.05)。结论导尿管腹部固定降低了留置尿管脑卒中患者的不适、疼痛及泌尿系感染风险。

OBJECTIVE To explore the influence of abdominal fixation approach of indwelling catheter on urinary tract infections and comfort degree of stroke patients so as to provide guidance for catheter indwelling of the stroke patients. METHODS A total of 100 stroke patients who were supposed to be treated with indwelling catheter from Jan 2014 to Jun 2015 were recruited as the study objects and were randomly divided into the observation group and the control group, with 50 cases in each. The observation group was treated with abdominal fixation of indwelling catheter, while the control group was given inner thigh fixation of indwelling catheter. The incidence of stroke-related infections was observed and compared between the two groups of patients after the one week, and the com- fort degree was compared between the two groups of patients. RESULTS The incidence of urinary tract infection of the observation group was 4.0%, significantly lower than 16.0% of the control group（P〈0.05）. The incidence rates of blocked catheter drainage, skin indentation, and deformation of catheter of the observation group were respectively 4.0%, 24.0%, and 8.0%, significantly lower than 16.0%, 80.0%, and 30.0% of the control group （P〈0.05）. The incidence rates of difficult turning over, difficult perineum nursing, difficult observation, and uncomfortable feelings of the observation group were respectively 8.0K, 2.0%, 2.0%, and 4.0%, significantly lower than 30.0%, 16.0%, 30.0%, and 16.0% of the control group（P〈0.05）. The constituent ratios of the grade Ⅰ , Ⅱ , and Ⅲ pain of the observation group were respectively 20.0%, 4.0%, and 1.0%, lower than 48.0%, 16.0%, and 8. 0% of the control group; the pain score of the observation group was （3. 33±0. 52） points, lower than （5.32 ±0.69） points of the control group（P〈0.05）. CONCLUSION The abdominal fixation of indwelling catheter may improve the degree of comfort, relieve the pain, and reduce the risk of urinary tract infections in the stroke patients.