重症脑卒中患者留置尿管漏尿相关因素分析

Influencing factors of urinary leakage in severe stroke patients indwelled with catheters

目的分析重症脑卒中留置尿管患者漏尿的影响因素并提出处理对策。方法通过查阅文献,筛查出留置尿管患者漏尿的原因主要包括尿管的型号、材质、是否感染、堵塞等。自制患者漏尿监测表,收集2018年1月至2020年12月广州医科大学附属第一医院神经重症病房110例(男71例,女39例,年龄19~86岁)留置尿管重症脑卒中患者的临床资料并进行统计学分析,探讨漏尿的影响因素。单因素分析两组间计量资料采用t检验,多组间计量资料采用方差分析。结果110例重症脑卒中留置尿管患者中,有22例患者出现了漏尿,单因素分析中显示存在漏尿患者与非漏尿患者在年龄因素、文化程度因素、性别因素、尿管型号、气囊注水量、腹泻因素上差异无统计学意义(均P>0.05),在住院天数、留置尿管天数、便秘、尿沉渣、发热、胃潴留、腹胀等差异有统计意义(均P<0.05);logistics回归分析显示住院天数、留置尿管天数、便秘、腹胀、尿沉渣为留置尿管漏尿的因素。结论重症脑卒中留置尿管患者漏尿发生率较高,应做好尿管管理,加强引起漏尿因素的控制和预防,可减少漏尿的发生。

Objective To analyze the influencing factors of urinary leakage in severe stroke patients indwelled with catheters,and to put forward the treatment countermeasures.Methods By consulting the literatures,the causes of urinary leakage in the patients indwelled with catheters were screened,mainly including the type,material,infection,blockage,and so on.The clinical data of 110 severe stroke patients indwelled with catheters in the neurological intensive care unit of First Hospital,Guangzhou Medical University from January 2018 to December 2020 were collected and statistically analyzed,and the influencing factors of leakage were explored.The measurement data were compared between two groups by t test and between more than two groups by ANOVA,and the univariate analysis was did.Results Among the 110 patients,22 had urinary leakage.The univariate analysis showed that there were no statistical differences between the patients with urinary leakage and the patients without urinary leakage in age,education level,gender,type of urinary catheter,amount of air bag injection,and diarrhea(all P>0.05),and were in length of hospital stay,days of indwelling catheter,constipation,urine sediment,fever,gastric retention,and abdominal distension(all P<0.05).Logistic regression analysis showed that the length of hospital stay,the length of indwelling catheter,constipation,abdominal distention,and urinary sediment were the factors of urinary leakage.Conclusions The incidence of urinary leakage in severe stroke patients indwelled with urinary catheters is high.We should do a good job in urinary catheter management and strengthen the control and prevention of factors causing urinary leakage,so as to reduce the incidence of urinary leakage.