氯己定会阴护理预防高龄ICU患者导尿管相关尿路感染的效果

Effect of chlorhexidine solution in nursing perineum on the prevention of urinary catheter-related urinary tract infection in elderly ICU patients

目的探讨应用0.05%醋酸氯己定溶液行会阴护理对预防高龄ICU患者导尿管相关尿路感染的效果。方法选取2018年1月-2019年12月于ICU住院的196名留置导尿管的高龄患者,随机分为试验组96例和对照组100例。试验组采用0.05%醋酸氯己定溶液进行会阴护理,对照组采用温开水进行会阴护理。比较两组患者在留置尿管的第7天、14天、21天、30天导尿管相关尿路感染发生率。结果留置导尿管第7天、14天、21天、30天时,试验组导尿管相关尿路感染发生率分别为0、0、2.08%、6.25%,对照组导尿管相关尿路感染发生率分别为3.00%、13.00%、29.00%、54.00%;第14、21、30天试验组导尿管相关尿路感染发生率均低于对照组(P<0.001)。结论对高龄ICU患者应用0.05%醋酸氯己定溶液进行会阴护理能降低导尿管相关尿路感染的发生率。

OBJECTIVE To investigate the effect of perineal care with 0.05% chlorhexidine solution on the prevention of catheter associated urinary tract infection(CAUTI) in elderly intensive care unit(ICU) patients. METHODS A total of 196 elderly ICU patients with long-term indwelling urinary catheters who were admitted to ICU from Jan. 2018 to Dec. 2019 were selected and randomly divided into 96 cases of experimental group and 100 cases of control group. The experimental group were treated with 0.05% chlorhexidine acetate solution for perineal care, and the control group were treated with warm boiled-water for perineal care. The incidence of CAUTI on the 7 th, 14 th, 21 st, and 30 th day of the indwelling catheter was compared between the two groups using chi-square test. RESULTS On the 7 th, 14 th, 21 st, and 30 th day of indwelling catheter, the incidence of CAUTI in the experimental group was 0, 0, 2.08% and 6.25%, respectively, while that in the control group was 3.00%, 13.00%, 29.00% and 54.00%, respectively. The incidence of CAUTI in the experimental group was significantly lower than that in the control group on day 14, 21 and 30(P<0.001). CONCLUSION The use of 0.05% chlorhexidine solution for perineal care in elderly ICU patients can reduce the incidence of CAUTI.