脑卒中后尿路感染的危险因素及预防措施

Risk factors and preventive measures of urinary tract infection after stroke

尿路感染是脑卒中后处于恢复期、康复期患者常见的并发症,且脑卒中后感染可加重原有的神经功能缺损症状,延长住院时间,影响近期及远期预后。脑卒中后神经源性膀胱发生的一些改变如膀胱过度充盈、压力增高、顺应性减低、输尿管膀胱反流等是尿路感染发生的病理基础;脑卒中后尿潴留的引流方式如留置导尿、间歇清洁自家导尿等直接诱发了尿路感染的发生;脑卒中病变程度、康复介入时间、患者年龄、性别、糖尿病、贫血、低蛋白血症等均是卒中后尿路感染的危险因素。为预防脑卒中后尿路感染的发生,可积极采取预防措施,如规范导尿并尽早去除尿管或间歇清洁自家导尿;积极治疗原发病,缩短住院时间,尽早康复治疗,早期下床;加强营养,控制血糖,纠正贫血、低蛋白血症,增强抵抗力;保持环境卫生和个人卫生清洁,个性化舒适护理;循环口服抗生素预防尿路感染。

Urinary tract infection is a common complication in patients who are recovering and recovering from stroke.Infection after stroke can induce the original symptoms of neurological deficits,prolong the length of hospital stay,and affect the short-term and long-term prognosis.Some changes of neurogenic bladder after stroke,such as overfilling of the bladder,increased bladder pressure,decreased bladder compliance,and ureteral bladder reflux,are the pathological basis for urinary tract infections;the drainage methods of urinary retention after stroke,such as indwelling catheterization,intermittent home clean catheterization,directly induce the occurrence of urinary tract infections;stroke severity,rehabilitation intervention time,patient age,gender,diabetes,anemia,and hypoalbuminemia are all risk factors for urinary tract infections after stroke.To prevent the occurrence of urinary tract infections after stroke,the following preventive measures can be actively taken.Standardize urinary catheterization and remove urinary catheters or clean your urinary catheters as soon as possible;actively treat the primary disease,shorten the length of hospital stay,recover early,get out of bed early;strengthen nutrition,control blood sugar,correct anemia,hypoalbuminemia,and increase resistance;Maintain environmental hygiene and personal hygiene clean,personalized and comfortable care;circulating oral antibiotics to prevent urinary tract infections.