本文關(guān)鍵詞：重癥患者導(dǎo)管相關(guān)性尿路感染的影響因素及差異性分析　出處：《第三軍醫(yī)大學(xué)學(xué)報》2016年09期 　論文類型：期刊論文

  更多相關(guān)文章： 留置尿管 CAUTI 影響因素 Logistic回歸

【摘要】：目的探討重癥患者導(dǎo)管相關(guān)性尿路感染(catheter-associated urinary tract infections,CAUTI)的影響因素及差異性。方法采用自行設(shè)計的經(jīng)過信度和效度檢驗的留置尿管評估觀察表,前瞻性監(jiān)測某院13個病區(qū)留置尿管的重癥住院患者654例,包括本科室置管和帶管入院2組患者CAUTI的影響因素并分析其差異性。結(jié)果本科室置管的重癥患者417例,發(fā)生CAUTI 56例,CAUTI影響因素的多因素分析結(jié)果顯示:女性,OR=5.937,95%CI(1.474~23.909);ICU置管,OR=60.499,95%CI(1.455~2515.992);置管前未預(yù)先連接尿管與集尿袋,OR=5.585,95%CI(1.278~24.411);置管時手觸摸尿管前端,OR=9.802,95%CI(2.413~39.816);尿管留置時間≥7 d,OR=47.652,95%CI(9.733~233.297);尿管留置時間≥14 d,OR=334.843,95%CI(56.700~1977.434);乳膠尿管,OR=0.158,95%CI(0.037~0.671)。帶管入院237例,發(fā)生CAUTI 38例,Logistic回歸分析結(jié)果顯示:尿管留置時間≥7 d,OR=7.277,95%CI(2.004~26.420);尿管留置時間≥14 d,OR=57.492,95%CI(16.549~199.728);置管后未更換引流袋,OR=3.429,95%CI(1.245~9.443);乳膠尿管,OR=0.323,95%CI(0.123~0.846)。2組重癥患者CAUTI影響因素差異性分析結(jié)果顯示:心血管疾病、慢性呼吸道疾病、三腔尿管、更換引流袋及普通引流袋對本科室置管組重癥患者CAUTI的影響稍大于帶管入院組,而尿管留置時間及乳膠尿管對本科室置管組重癥患者CAUTI的影響稍小于帶管入院組,2組差異有統(tǒng)計學(xué)意義(P0.05)。結(jié)論女性、ICU置管、置管前未預(yù)先連接尿管與集尿袋、置管時手觸摸尿管前端及尿管留置時間是本科室置管重癥患者CAUTI的危險因素,乳膠尿管則是保護因素;尿管留置時間和置管后未更換引流袋是帶管入院重癥患者CAUTI的危險因素,乳膠尿管也是保護因素。針對相關(guān)因素進行預(yù)防性干預(yù)和規(guī)范護理,對降低CAUTI發(fā)生率具有重要意義。
[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.
【作者單位】： 第三軍醫(yī)大學(xué)大坪醫(yī)院野戰(zhàn)外科研究所護理部;第三軍醫(yī)大學(xué)大坪醫(yī)院野戰(zhàn)外科研究所ICU;第三軍醫(yī)大學(xué)大坪醫(yī)院野戰(zhàn)外科研究所感控科;
【基金】：第三軍醫(yī)大學(xué)大坪醫(yī)院護理科研基金(HLKYJJ2014001)~~
【分類號】：R691.3
【正文快照】： 外科研究所:護理部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導(dǎo)管相關(guān)性尿路感染(catheter-associated urinar

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