全麻术后导尿管插管患者发生尿路感染的危险因素分析

Analysis of risk factors of urinary tract infection in patients with postoperative catheterization after general anesthesia

目的探讨全麻术后导尿管插管患者发生尿路感染危险因素。方法回顾性分析2015年6月-2017年6月本院手术室接受全麻术的428例导尿管插管患者的临床资料。根据患者是否发生尿路感染,分为感染组35例和未感染组393例,采用Logicstics回归分析确定全麻术后导尿管插管患者发生尿路感染的危险因素。结果 428例全麻术后导尿管插管患者发生尿路感染35例,感染率为8.17%;35例尿路感染患者培养出104株病原菌,Logicstics回归分析显示,有留置导尿管时间(≥5 d)、导尿管插管困难、麻醉时间(≥3 h)及糖尿病史是全麻术后导尿管插管患者发生尿路感染的独立危险因素(P<0.05),应用抗生素是尿路感染的保护因素,有导尿管插管困难的患者表现出更高尿路感染风险(OR=6.788,95%CI:3.277~14.063,P<0.05)。结论全麻术后导尿管插管患者发生尿路感染危险因素较多,临床应针对相关危险因素采取预防措施,以降低全麻术后导尿管插管患者发生尿路感染的发生率。

Objective To investigate the risk factors of urinary tract infection in patients with catheterization after general anesthesia. Methods We retrospectively analyzed the clinical data of 428 catheterization patients undergoing general anesthesia from June 2015 to June 2017. According to whether the patient suffered urinary tract infection,they were divided into the infection group（35 cases） and in the uninfected group（393 cases）. Logicstics regression analysis was used to determine the risk factors for urinary tract infection in catheterization patients after general anesthesia. Results Thirty-five cases suffered urinary tract infections in 428 patients with catheterization after general anesthesia,with the infection rate of 8. 17%. 104 strains of pathogenic bacteria were cultured from 35 patients with urinary tract infections. Logisticstics regression analysis showed that indwelling catheter time（≥ 5 d）,catheter intubation difficulty,anesthesia time（≥3 h） and history of diabetes were independent risk factors for urinary tract infection in patients undergoing catheterization after general anesthesia（P〈0. 05）. Antibiotics application was the protective factor for urinary tract infections. Patients with catheterization difficulty showed a higher risk of urinary tract infection（OR = 6. 788,95% CI： 3. 277-14. 063,P〈0. 05）. Conclusion There are many risk factors for urinary tract infection in patients undergoing catheterization after general anesthesia. Preventive measures should be taken in response to relevant risk factors to reduce the incidence of urinary tract infections in patients undergoing catheterization after general anesthesia.