脑卒中住院康复患者尿路感染危险因素分析
摘要
目的:探讨脑卒中住院康复患者发生尿路感染的危险因素。方法:采用回顾性调查方法,收集268例脑卒中首次住院康复患者一般临床资料,包括性别、年龄、住院时间、病程、Brunnstrom分期、Barthel指数、有无留置导尿、有无认知障碍、有无失语症、既往高血压病史、既往糖尿病病史、吸烟饮酒史、白蛋白及血红蛋白指标。按有无尿路感染分2组,观察并分析2组一般临床资料,分析分类变量之间的差异,对所有变量再进行多因素Logistic逐步回归分析。结果:2组间性别、年龄、住院时间、病程、Barthel指数、Brunnstrom分期(上肢-手-下肢)、留置导尿、白蛋白含量、血红蛋白含量、失语症差异有显著性意义(P<0.05);多因素Logistic逐步回归分析显示,性别、住院时间、Barthel指数、留置导尿是发生尿路感染的独立危险因素(P<0.05,0.01)。结论:性别、住院时间、Barthel指数、留置导尿是发生尿路感染的独立危险因素,针对这些危险因素,采取积极有效预防措施,有助预防尿路感染发生。
引文
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[2] Hamidon BB,Raymond AA,Norlinah MI,et al.The predictors of early infection after an acute ischaemic stroke[J].Singapore Med J,2003,44(7):344-346.
[3] Stott DJ,Falconer A,Miller H,et al.Urinary tract infection after stroke[J].QJM,2009,102(4):243-249.
[4] Bogason E,Morrison K,Zalatimo O,et al.Urinary tract infections in hospitalized ischemic stroke patients:source and impact on outcome[J].Cureus,2017,9(2):e1014.
[5] 中华神经科学会,中华神经外科学会.各类脑血管疾病诊断要点[J].中华神经科杂志,1996,29(6):379-380.
[6] 牟姗,张庆怡.尿路感染的诊断和鉴别诊断[J].中国实用内科杂志,2001,21(4):203-204.
[7] Yan T,Liu C,Li Y,et al.Prevalence and predictive factors of urinary tract infection among patients with stroke:A meta-analysis[J].Am J Infect Control,2018,46(4):402-409.
[8] Kim BR,Lim JH,Lee SA,et al.The Relation between Postvoid Residual and Occurrence of Urinary Tract Infection after Stroke in Rehabilitation Unit[J].Ann Rehabil Med,2012,36(2):248-253.
[9] Maki DG,Tambyah PA.Engineering out the risk for infection with urinary catheters [J].Emerg Infect Dis.2001,7(2):342-347.
[10] Cowey E,Smith LN,Booth J,et al.Urinary catheterization in acute stroke:Clinical realities.A mixed methods study[J].Clin Rehab,2012,26(5):470-479.
[11] Gould CV,Umscheid CA,Agarwal RK,et al.Guideline for prevention of catheter-associated urinary tract infections[J].Infect Control Hosp Epidemiol,2010,31(4):319-326.
[12] Winstein CJ,Stein J,Arena R,et al.Guidelines for Adult Stroke Rehabilitation and Recovery:A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association[J].Stroke,2016,47(6):e98-e169.
[13] 张通.中国脑卒中康复治疗指南(2011完全版)[J].中国康复理论与实践,2012,18(4):301-318.
[14] 温会新,刘长杰,徐连成.脑卒中患者早期进行肠内营养支持的临床研究[J].河北医药,2009,31(14):1755-1756.
[15] 李晓利,范利,王强,等.贫血对老年患者远期缺血性动脉血栓事件及死亡住院风险的预测[J].中华老年心脑血管病杂志,2018,20(9):919-922.