中药煎剂联合集束化护理会阴冲洗对预防ICU长期卧床老年患者导尿管相关性尿路感染的疗效观察

Effect Observation of the Traditional Chinese Medicine Decoction Combined with Care Bundles Perineal Flushing on Prevention of Catheter Related Urinary Tract Infection for Long-term Bedridden Elderly Patients in ICU

目的 观察中药煎剂联合集束化护理会阴冲洗对降低ICU长期卧床老年患者导尿管相关性尿路感染的影响。方法 选取山东中医药大学附属医院重症医学科2021年1月1日至2022年6月30日期间住院的卧床时间≥30 d,排除膀胱造瘘的年龄≥60岁的老年非炎性留置导尿患者为研究对象。采用随机数字表法将患者分为两组,每组30名。对照组给予常规护理,观察组在对照组的基础上采用中药煎剂联合集束化护理会阴冲洗进行日常护理。观察两组在第7、14、21、28天患者是否有尿路刺激征、尿液及沉渣中的白细胞计数、尿液细菌培养结果,以此判断患者泌尿系统感染情况。结果 两组第7、14天的尿道白细胞计数及感染发生率没有显著性差异,第21、28天时比较差异有统计学意义(P<0.05)。结论 中药煎剂联合集束化护理会阴冲洗可降低ICU长期卧床老年患者导尿管相关性尿路感染的发生率,缩短了住院时间,提高了生存质量。

Objective:To investigate the effect of traditional Chinese medicine decoction combined with care bundles perineal flushing on reducing catheter related urinary tract infection in long term bedridden elderly patients in ICU,in order to reduce the incidence of catheter related urinary tract infection in ICU.Methods:The subjects were selected from the Department of Intensive Care Medicine,the Affliated Hospital of Shandong University of Traditional Chinese Medicine,who were hospitalized from January 1,2021 to June 30,2022,and whose bedridden time was≥30 days.The elderly patients with non-inflammatory indwelling catheterization who were≥60 years old after cystostomy were excluded from the study.Using a random number table method,patients were divided into two groups of 30 patients with different nursing methods.The control group received routine care,while the observation group received routine care using traditional Chinese medicine decoction combined with care bundles perineal flushing on the basis of the control group.Whether the patients in each group had urinary tract irritation signs,white blood cell counts in urine and sediment,and urine bacterial culture results on the 7th,14th,21st,and 28th days were observed and compared to judge the clinical urinary system infection of patients.Results:There was no significant difference in the urinary white blood cell count and infection incidence between the two groups on the 7th and 14th days,but there was statistical significance on the 21st and 28th days(P<0.05).Conclusion:The combination of traditional Chinese medicine decoction and care bundles perineal flushing can reduce the incidence of catheter related urinary tract infection in long-term bedridden elderly patients in ICU,shorten the hospitalization time of patients,and improve the quality of life of patients,which is worthy of clinical reference.