康复期截瘫患者泌尿系感染反复发作的特点调查分析

Investigation and analysis of the characteristics in recurrent urinary tract infections of paraplegia patients with convalescence

目的探讨康复期截瘫患者泌尿系感染反复发作的特点,为患者泌尿系感染反复发作的预防治疗提供参考。方法选取医院2015年1月-2016年6月诊治的康复期截瘫泌尿系感染患者100例,对患者相关资料进行调查,分析结果。结果 76例患者为泌尿系感染反复发作,占76.00%,24例患者为初次感染,占24.00%;76例泌尿系感染反复发作患者中段尿培养阳性者56例,阳性率为73.68%,培养出菌株61株,其中革兰阴性菌36株、革兰阳性菌21株、支原体与衣原体各2株,分别占59.02%、34.43%、3.28%、3.28%,主要感染病原菌为大肠埃希菌,占检出病原菌的39.34%;不同性别、年龄、截瘫类型及留置尿管方式对泌尿系感染反复发作无影响,泌尿系感染反复发作率完全性截瘫、合并尿路结石时分别为85.96%、100.00%,高于不完全截瘫、未合并尿路结石时62.79%、71.76%,截瘫时间>2年时为84.78%,高于<1年、1~2年时45.45%、74.42%,比较差异有统计学意义(P<0.05)。结论康复期截瘫患者容易出现泌尿系感染反复发作,感染病原菌主要以大肠埃希菌为主的革兰阴性菌,合并有尿路结石、完全性截瘫及截瘫时间长的患者更容易出现泌尿系感染的反复发作是其特点。

OBJECTIVE To discuss the characteristics in recurrent urinary tract infections of paraplegia patients with convalescence, so as to provide references for the prevention and control of recurrent urinary tract infections. METHODS A total of 100 cases of urinary tract infections in paraplegia patients with convalescence from Jan. 2015 to Jun. 2016 were selected. The relevant data of the patients were investigated, and the results were analyzed. RESULTS The recurrent urinary tract infections were 76 cases, accounting for 76.00 %, and the primary infections were 24 cases, accounting for 24.00G. There were 56 cases of urine culture positive patients in 76 patients with recurrent urinary tract infections, with the positive rate of 73.68%. Totally 61 strains were cultured, including 36 strains of gram-negative bacteria, 21 strains of gram-positive bacteria, 2 strains of mycoplasrna and 2 strains of chlamydia, accounting for 59. 02%, 34. 43%, 3. 28% and 3. 28G, respectively. The main pathogenic bacteria were Escherichia coli, which accounted for 39.34%. Different genders, ages, types of paraplegia arid indwelling catheter had no effect on recurrent episodes of urinary tract infections. Recurrent urinary tract infection rates were 85.96 %and 100. 00 % of complete paraplegia and urinary calculi, which were higher than 62.79% and 71.76 %of no complete paraplegia and no urinary calculi. Recurrent urinary tract infection rate was 84.78% in patients with Paraplegia time 〉 2 years, which was higher than 45.45 % of paraplegia time 〈1 years and 74.42 % of paraplegia time of 1-2 years, and the difference was significant （P〈0.05）. CONCLUSION Recurrent paraplegia patients are prone to recurrent urinary tract infection, gram-negative bacteria dominated by E. coli are the main pathogens, and patients with urinary tract stones, complete paraplegia and paraplegia for a long time are more likely to have recurrent episodes of urinary tract infections.