小儿留置导尿管尿路感染的相关影响因素及预防性护理措施分析

Analysis of influencing factors and preventive care measures related to urinary tract infection in children with indwelling urinary catheters

目的 探讨小儿留置导尿管尿路感染的相关影响因素及预防性护理措施,为后续小儿留置导尿管尿路感染的防护提供依据。方法 80例留置导尿管的患儿为研究对象,依据留置导尿管期间是否发生尿路感染分为感染组(11例)与未感染组(69例)。收集两组患儿的临床资料,探讨小儿留置导尿管尿路感染的相关影响因素。结果 80例患儿发生尿路感染11例,发生率为13.75%(11/80)。单因素分析显示,两组不同年龄、导尿管留置时间、住院时间、更换导尿管次数、导尿口护理、手术治疗、导尿管插管困难、低蛋白血症、使用抗菌药物、膀胱冲洗、既往留置导尿管史患儿的尿路感染发生率比较,差异具有统计学意义(P<0.05);两组不同性别、体质量患儿的尿路感染发生率比较,差异无统计学意义(P>0.05)。Logistic多因素分析显示,年龄<6岁、导尿管留置时间≥3 d、住院时间≥7 d、更换导尿管次数≥2次、无导尿口护理、手术治疗、导尿管插管困难、低蛋白血症、使用抗菌药物、膀胱冲洗、既往留置导尿管史是小儿留置导尿管尿路感染的独立危险因素(OR=5.850、5.697、7.442、5.000、5.203、9.714、6.533、8.157、7.018、6.300、8.000, P<0.05)。结论 小儿留置导尿管尿路感染风险较高,其中年龄<6岁、导尿管留置时间≥3 d、住院时间≥7 d、更换导尿管次数≥2次、无导尿口护理、手术治疗、导尿管插管困难、低蛋白血症、使用抗菌药物、膀胱冲洗、既往留置导尿管史是小儿留置导尿管尿路感染的独立危险因素,临床需尽早开展针对性预防护理措施,以减少尿路感染发生。

Objective To discuss the influencing factors and preventive care measures related to urinary tract infection in children with indwelling urinary catheters,so as to provide basis for the protection of urinary tract infection in children with indwelling catheter.Methods 80 children with indwelling urinary catheters were divided into infected group(11 cases)and uninfected group(69 cases)according to whether urinary tract infection occurred during indwelling catheter.Clinical data of two groups of children were collected to explore the related factors of urinary tract infection in children with indwelling urinary catheters.Results 11 out of 80 children developed urinary tract infections,with an incidence rate of 13.75%(11/80).Univariate analysis showed that there were statistically significant differences in the incidence of urinary tract infection between the two groups of children with different ages,catheter indwelling time,length of hospital stay,number of catheter changes,urethral catheter care,surgical treatment,catheter intubation difficulties,hypoproteinemia,antimicrobial use,bladder irrigation,and previous history of indwelling urinary catheter(P<0.05).There was no statistically significant difference in the incidence of urinary tract infection between the two groups of children with different gender and body weight(P>0.05).Logistic multivariate analysis showed that age<6 years,catheter indwelling time≥3 d,length of hospital stay≥7 d,number of catheter changes≥2 times,no urethral catheter care,surgical treatment,catheter intubation difficulties,hypoproteinemia,antimicrobial use,bladder irrigation,and previous history of indwelling urinary catheter were independent risk factors for urinary tract infection in children with indwelling urinary catheters(OR=5.850,5.697,7.442,5.000,5.203,9.714,6.533,8.157,7.018,6.300,8.000;P<0.05).Conclusion Children with indwelling urinary catheter have a higher risk of urinary tract infection.Age<6 years,catheter indwelling time≥3 d,length of hospital stay≥7 d,number of catheter changes≥2 times,no urethral catheter care,surgical treatment,catheter intubation difficulties,hypoproteinemia,antimicrobial use,bladder irrigation,and previous history of indwelling urinary catheter are independent risk factors for urinary tract infection in children with indwelling urinary catheters,and it is necessary to carry out targeted preventive care measures as soon as possible to reduce the occurrence of urinary tract infection.