筑建抗菌膜密闭系统在预防导尿管相关性尿路感染的效果分析

Analysis of effect by antibacterial film sealed system establishment in prevention of catheter-associated urinary tract infection

目的探讨筑建抗菌膜密闭系统在预防导尿管相关性尿路感染中的应用效果。方法 330例住院留置导尿管患者作为研究对象,按照随机数字表法分为A、B、C组,每组110例。A组采用0.1%的碘伏稀释液消毒尿道口;B组采用长效抗菌材料(洁悠神)喷洒尿道口周围皮肤及黏膜;C组采用洁悠神喷洒导尿管内外面、尿道口周围皮肤及黏膜、导尿管体外段、尿袋与尿管接口及尿袋出口,构建抗菌膜密闭引流系统。分别于用药后的第1、3、7、14天行尿沉渣检测及尿液细菌培养,比较三组患者尿白细胞、尿路感染情况。结果 (1)尿液白细胞计数:第1天三组患者尿液均未见白细胞;第3天,C组患者尿液未见白细胞,B组患者白细胞计数明显低于A组患者(P<0.05);第7天,C组患者仍未见白细胞,B组患者白细胞计数明显低于A组患者(P<0.05);第14天,C组患者白细胞计数低于B组患者,同时B组患者白细胞计数低于A组患者,组间两两比较,差异均具有统计学意义(P<0.05)。(2)尿路感染发生情况:第1天,三组患者均未见感染;第3天,C组无感染,B组1例感染,A组3例感染,A、B两组感染率(2.7%VS 0.9%)比较差异无统计学意义(P>0.05);第7天,C组仍无感染,B组8例感染,A组19例感染,B组感染率7.3%明显低于A组17.3%(P<0.05);第14天,C组感染1例,B组感染13例,A组感染25例,C组感染率0.9%低于B组11.8%,B组感染率11.8%低于A组22.7%,组间两两比较,差异均具有统计学意义(P<0.05)。结论筑建抗菌膜密闭系统能够明显降低留置导尿管相关性尿路感染的发生率,其操作简单,安全性好,值得推广。

Objective To investigate application effect by antibacterial film sealed system establishment in prevention of catheter-associated urinary tract infection. Methods A total of 330 hospitalized patients with indwelling catheter as study subjects were divided by random number table into group A, group B and group C, with 110 cases in each group. Group A received 0.1% indophor diluents for urethral orifice disinfection, group B received long-acting antibacterial material（JUC） for urethral orifice surrounding skin and mucous membrane spraying, and group C received antibacterial film sealed system establishment by JUC spraying on internal and external catheter surface, urethral orifice surrounding skin and mucous membrane, in vitro catheter segments, connector between urine bag and catheter, and urine bag exit. Urinary sediment detection and urine bacteria culture were taken in 1, 3, 7, 14 d after medication to compare urine white blood cell and urinary tract infection condition in the three groups. Results（1） Urine white blood cell count： There was no urine white blood cell in all three groups at 1 d. At 3 d, group C showed no urine white blood cell, while group B had obviously lower white blood cell count than group A（P〈0.05）. At 7 d, there was still no urine white blood cell in group C, while group B had obviously lower white blood cell count than group A（P〈0.05）. At 14 d, group C had lower white blood cell count than group B, and group B also had lower white blood cell count than group A, and their differences all had statistical significance（P〈0.05）.（2） Occurrence of urinary tract infection： At 1 d, no infection was shown in all three groups. At 3 d, group C had no infection case, while group B had 1 infection case and group A had 3 infection cases. The difference of infection rate between group A and group B（2.7% VS 0.9%） had no statistical significance（P〈0.05）. At 7 d, group C had no infection case, while group B had 8 infection cases and group A had 19 infection cases. Group B had obviously lower infection rate as 7.3% than 17.3% in group A（P〈0.05）. At 14 d, there was 1 infection case in group C, 13 infection cases in group B and 25 infection cases in group A. Group C had lower infection rate as 0.9% than 11.8% in group B, and group B had lower infection rate as 11.8% than 22.7% in group A. Their differences all had statistical significance（P〈0.05）. Conclusion Antibacterial film sealed system establishment can remarkably lower incidence of catheter-associated urinary tract infection, along with easy operation and excellent safety. This method is worth promoting.