输尿管镜治疗上尿路结石患者术后泌尿系统感染的高危因素分析与护理干预

Analysis of high-risk factors of postoperative urinary system infection after ureteroscopy is used to treat in patients with upper urinary tract stones and its nursing interventions

目的探讨输尿管镜治疗上尿路结石术后泌尿系统感染的高危因素,并提出相关护理干预措施。方法回顾性分析2009年9月至2017年12月1126例接受输尿管镜治疗的上尿路结石患者资料,收集术后发生泌尿系感染情况并进行病原学检测,统计患者性别、年龄、病史、手术时间、抗菌药物使用等临床资料,分析泌尿系统感染的高危因素。结果1126例上尿路结石患者中44例术后发生泌尿系感染,其中肾盂肾炎28例;44例感染患者中培养出80株病原菌,包含革兰阳性菌22株,革兰阴性菌58株,以大肠埃希菌和金黄色葡萄球菌为主。多因素logistic回归分析显示,肾积水、置入导尿管、术前尿潴留成为输尿管镜术后患者泌尿系统感染的独立危险因素(P<0.05),而预防使用抗菌药物是其保护因素(P<0.05)。结论输尿管镜治疗上尿路结石患者术后可感染多种病原菌,以肾盂肾炎为主,预防性抗菌药物使用可减少感染率,针对输尿管镜术后泌尿系统感染的危险因素,日常工作中严加防范,以减少感染概率。

Objective To explore the high-risk factors of postoperative urinary system infection after ureteroscopy is used to treat in patients with upper urinary tract stones,and propose relevant nursing interventions.Methods We retrospectively analyzed the data of 1’126 patients with upper urinary tract stones who underwent ureteroscopy from September 2009 to December 2017,collected the conditions of postoperative urinary tract infections and conducted pathogenic testing,at same time,counted the patient's gender,age,medical history,operation time,use of antibacterial drug,and other clinical data to analyze the high-risk factors of urinary system infection.Results Among the 1,126 patients with upper urinary tract stones,44 cases developed urinary tract infections,including 28 cases of pyelonephritis,80 pathogenic bacteria were cultured in 44 cases of infection,including 22 gram-positive bacteria and 58 gram-negative bacteria,it was mainly escherichia coli and staphylococcus aureus.Multivariate logistic regression analysis showed that the hydronephrosis,catheterization,and preoperative urinary retention were the independent risk factors for urinary system infection in patients after ureteroscopy(P<0.05),and preventive use of antibiotics was the protective factor(P<0.05).Conclusion After upper urinary tract stones treated by ureteroscopy,patients can be infected with a variety of pathogenic bacteria,mainly pyelonephritis.The use of preventive antibiotics can reduce the infection rate.For the risk factors of urinary system infection after ureteroscopy,daily work was strictly taken precautions to reduce the probability of infection.