下肢骨折术后留置尿管患者导尿管相关尿路感染危险因素分析
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摘要
目的研究下肢骨折术后留置尿管患者导尿管相关尿路感染(CAUTI)的危险因素,为防控CAUTI的发生提供依据。方法采用回顾性分析方法,对某医院住院行下肢骨折术后留置导尿管患者的CAUTI相关临床资料进行统计分析。结果共分析该医院下肢骨折术后留置尿管患者322例,发生CAUTI 50例,CAUTI发生率为15. 53%。Logistic多因素回归分析显示,患者年龄、基础疾病、留置时间、麻醉方式、镇痛泵给药途径、卧床时间和骨折部位是下肢骨折术后留置尿管患者CAUTI发生的独立危险因素(P <0. 05)。结论 CAUTI骨科患者术后留置尿管最常见的医院感染之一,应结合分析的危险因素采取针对性的措施。
Objective To study the risk factors of urinary catheter-associated urinary tract infection( CAUTI) in patients with indwelling ureter after lower limb fracture,and to provide evidence for prevention and control of CAUTI. Methods Retrospective investigation was used to analyze clinical data associated with patients with indwelling ureter after lower limb fracture. Results A total of 322 patients with urinary catheter indwelling after lower limb fracture in the hospital were analyzed,50 of them had CAUTI,and the incidence rate of urinary tract infection was 15. 53%. Logistic multivariate regression analysis showed that age,basic disease,indwelling time,anesthesia,analgesic pump administration,bed rest time,and fracture site were independent risk factors for CAUTI in patients with indwelling ureter after lower limb fracture( P < 0. 05).Conclusion CAUTI is one of the most common nosocomial infections of indwelling urinary catheter in postoperative patients,and prevention and control measures should be evaluated based on the risk factors analyzed,and targeted measures should be taken.
Objective To study the risk factors of urinary catheter-associated urinary tract infection( CAUTI) in patients with indwelling ureter after lower limb fracture,and to provide evidence for prevention and control of CAUTI. Methods Retrospective investigation was used to analyze clinical data associated with patients with indwelling ureter after lower limb fracture. Results A total of 322 patients with urinary catheter indwelling after lower limb fracture in the hospital were analyzed,50 of them had CAUTI,and the incidence rate of urinary tract infection was 15. 53%. Logistic multivariate regression analysis showed that age,basic disease,indwelling time,anesthesia,analgesic pump administration,bed rest time,and fracture site were independent risk factors for CAUTI in patients with indwelling ureter after lower limb fracture( P < 0. 05).Conclusion CAUTI is one of the most common nosocomial infections of indwelling urinary catheter in postoperative patients,and prevention and control measures should be evaluated based on the risk factors analyzed,and targeted measures should be taken.
引文
[1]Fritz JA,Pace M,Persing TF,et al.A performance improvemen tproject taking the prevention of catheter associated urinary tract infections into the 21st century[J].Am Infect Control,2016,41:121.
[2]Mann P,Vandygrif C,Kingsberry L,et al.Catheter-associated uri-nary tract infection(CAUTI):a significant case for concern[J].Am J Infect Control,2013,49:104.
[3]Akhtar N.Hospital acquired infections in a medical intensive careunit[J].J College Physicians Surgeons Pak,2014,20(6):386-390.
[4]Graves N,Tong E,Morton AP,et al.Factors associated with health care-acquired urinary tract infection[J].Am J Infect Control,2015,35(6):387-392.
[5]中华人民共和国卫生部.导尿管相关尿路感染预防与控制技术指南(试行)[S].2010.
[6]乜广珍,张冬梅,朱丽.老年髋部骨折患者术后短期留置尿管期间夹闭尿管的效果[J].广东医学,2015,36(11):3574-3576.
[7]马为民,苏军,李桂清.改进卧床排尿体位的效果观察[J].滨州医学院学报,2014,30(5):159-160.
[8]杨建超.不同麻醉方式对下肢骨科手术患者术后镇痛效果及排尿方式影响的对比[J].临床合理用药,2016,9(8):54-55.
[9]Salinas FV,Liu SS,Mulroy MF.The effect of single injection femoral nerve block versus continuous femoral nerve block after total knee ar throplasty on hospital length of stay and long-term functional recovery within an established clinical pathway[J].Anesth Analg,2016,102(4):1234.
[10]Fowler SJ,Symons J,Sabato S,et al.Epidural analgesia compared with peripheral nerve blockade after major knee surgery:a systematic review and meta-analysis of randomized trials[J].Br JAnaesth,2013,100(2):154-164.
[11]俞小红.护理干预对预防骨科术后镇痛泵所致尿潴留的效果评价[J].中国实用护理杂志,2012,28(18):44-45.
[12]Luyt CE,Chastre J,Fagon JY.Value of the clinical pulmonary infection score for the identification and management of ventilatorassociated pneumonia[J].Intensive Care Med,2004,30(5):844-852.
[2]Mann P,Vandygrif C,Kingsberry L,et al.Catheter-associated uri-nary tract infection(CAUTI):a significant case for concern[J].Am J Infect Control,2013,49:104.
[3]Akhtar N.Hospital acquired infections in a medical intensive careunit[J].J College Physicians Surgeons Pak,2014,20(6):386-390.
[4]Graves N,Tong E,Morton AP,et al.Factors associated with health care-acquired urinary tract infection[J].Am J Infect Control,2015,35(6):387-392.
[5]中华人民共和国卫生部.导尿管相关尿路感染预防与控制技术指南(试行)[S].2010.
[6]乜广珍,张冬梅,朱丽.老年髋部骨折患者术后短期留置尿管期间夹闭尿管的效果[J].广东医学,2015,36(11):3574-3576.
[7]马为民,苏军,李桂清.改进卧床排尿体位的效果观察[J].滨州医学院学报,2014,30(5):159-160.
[8]杨建超.不同麻醉方式对下肢骨科手术患者术后镇痛效果及排尿方式影响的对比[J].临床合理用药,2016,9(8):54-55.
[9]Salinas FV,Liu SS,Mulroy MF.The effect of single injection femoral nerve block versus continuous femoral nerve block after total knee ar throplasty on hospital length of stay and long-term functional recovery within an established clinical pathway[J].Anesth Analg,2016,102(4):1234.
[10]Fowler SJ,Symons J,Sabato S,et al.Epidural analgesia compared with peripheral nerve blockade after major knee surgery:a systematic review and meta-analysis of randomized trials[J].Br JAnaesth,2013,100(2):154-164.
[11]俞小红.护理干预对预防骨科术后镇痛泵所致尿潴留的效果评价[J].中国实用护理杂志,2012,28(18):44-45.
[12]Luyt CE,Chastre J,Fagon JY.Value of the clinical pulmonary infection score for the identification and management of ventilatorassociated pneumonia[J].Intensive Care Med,2004,30(5):844-852.