重症患者导管相关性尿路感染的影响因素及差异性分析

发布时间：2018-01-02 13:09

本文关键词：重症患者导管相关性尿路感染的影响因素及差异性分析　出处：《第三军医大学学报》2016年09期 　论文类型：期刊论文

【摘要】：目的探讨重症患者导管相关性尿路感染(catheter-associated urinary tract infections,CAUTI)的影响因素及差异性。方法采用自行设计的经过信度和效度检验的留置尿管评估观察表,前瞻性监测某院13个病区留置尿管的重症住院患者654例,包括本科室置管和带管入院2组患者CAUTI的影响因素并分析其差异性。结果本科室置管的重症患者417例,发生CAUTI 56例,CAUTI影响因素的多因素分析结果显示:女性,OR=5.937,95%CI(1.474~23.909);ICU置管,OR=60.499,95%CI(1.455~2515.992);置管前未预先连接尿管与集尿袋,OR=5.585,95%CI(1.278~24.411);置管时手触摸尿管前端,OR=9.802,95%CI(2.413~39.816);尿管留置时间≥7 d,OR=47.652,95%CI(9.733~233.297);尿管留置时间≥14 d,OR=334.843,95%CI(56.700~1977.434);乳胶尿管,OR=0.158,95%CI(0.037~0.671)。带管入院237例,发生CAUTI 38例,Logistic回归分析结果显示:尿管留置时间≥7 d,OR=7.277,95%CI(2.004~26.420);尿管留置时间≥14 d,OR=57.492,95%CI(16.549~199.728);置管后未更换引流袋,OR=3.429,95%CI(1.245~9.443);乳胶尿管,OR=0.323,95%CI(0.123~0.846)。2组重症患者CAUTI影响因素差异性分析结果显示:心血管疾病、慢性呼吸道疾病、三腔尿管、更换引流袋及普通引流袋对本科室置管组重症患者CAUTI的影响稍大于带管入院组,而尿管留置时间及乳胶尿管对本科室置管组重症患者CAUTI的影响稍小于带管入院组,2组差异有统计学意义(P0.05)。结论女性、ICU置管、置管前未预先连接尿管与集尿袋、置管时手触摸尿管前端及尿管留置时间是本科室置管重症患者CAUTI的危险因素,乳胶尿管则是保护因素;尿管留置时间和置管后未更换引流袋是带管入院重症患者CAUTI的危险因素,乳胶尿管也是保护因素。针对相关因素进行预防性干预和规范护理,对降低CAUTI发生率具有重要意义。
[Abstract]:Objective to investigate catheter-associated urinary tract infections (Catheter-associated urinary tract infections) in severe patients with catheter-associated urinary tract infection. Methods A self-designed indwelling urethral catheter was designed to evaluate the reliability and validity of the indwelling urethral catheter. 654 severe inpatients with indwelling urethral catheter in 13 wards of a hospital were prospectively monitored. The influencing factors of CAUTI in the two groups were analyzed and analyzed. Results there were 417 cases of severe patients and 56 cases of CAUTI. The results of multivariate analysis on the influencing factors of CAUTI showed that the female Organ was 5.937795% and 1.474 (23.909); ICU was placed in 60.499 / 95 and 1.455 / 2515.992C; Before catheterization, there was no pre-connection between urinary catheter and urine collecting pouch. During catheterization, the hands touch the anterior end of the urethral catheterization with an order of 9.802 ~ 95CII 2.413 ~ 39.816m; The indwelling time of urinary catheter was more than 7 days. The indwelling time of urethral catheter was more than 14 days. CAUTI was found in #number0# patients with urethra and 38 patients with CAUTI. The results of Logistic regression analysis showed that the indwelling time of urinary catheter was more than 7 days. The indwelling time of urinary catheter was more than 14 days. After placing the tube, the drainage bag was not replaced. The difference analysis of the influencing factors of CAUTI in the group of 0.323995 and 0.1230.466.2. the results showed that: cardiovascular disease. The effects of chronic respiratory diseases, three-lumen urethral catheter, replacement of drainage bag and common drainage bag on CAUTI in the group with tube insertion were slightly greater than those in the group with tube. However, the effect of indwelling time and latex catheter on the CAUTI of severe patients in this department group was slightly smaller than that of the two groups with tube. Conclusion there is a significant difference between the two groups. Conclusion the female patients have catheterization. Before catheterization, urine catheter and urine collection bag were not connected in advance. The risk factors of CAUTI in severe patients with catheterization were hand-touching the front end of catheter and indwelling time of catheterization, while latex urethral catheter was the protective factor. The indwelling time of urinary catheter and the unreplaced drainage bag were the risk factors of CAUTI in severe patients with catheterization, and latex urethral catheter was also the protective factor. Preventive intervention and standardized nursing were carried out according to the relevant factors. It is of great significance to reduce the incidence of CAUTI.
【作者单位】：第三军医大学大坪医院野战外科研究所护理部;第三军医大学大坪医院野战外科研究所ICU;第三军医大学大坪医院野战外科研究所感控科;
【基金】：第三军医大学大坪医院护理科研基金(HLKYJJ2014001)~~
【分类号】：R691.3
【正文快照】： 外科研究所:护理部1,ICU2,感控科3)Supported by the Nursing Scientific Research Fund of Daping Hospital of Third Military Medical University(HLKYJJ2014001).Corresponding author:ZengDengfen,E-mail:zdf_6688@163.com导管相关性尿路感染(catheter-associated urinar

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