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膀胱冲洗预防昏迷患者短期导尿相关性尿路感染的效果:一项随机对照临床试验。

Efficacy of bladder irrigation in preventing urinary tract infections associated with short-term catheterization in comatose patients: A randomized controlled clinical trial.

机构信息

School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran.

Mother & Child Care Research Center, Department of Medical Surgical Nursing, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran.

出版信息

Am J Infect Control. 2018 Oct;46(10):e45-e50. doi: 10.1016/j.ajic.2018.05.009. Epub 2018 Jun 19.

Abstract

BACKGROUND

Bladder irrigation can be performed to prevent catheter-associated urinary tract infections (CAUTI), but its efficacy has been not reported in short-term indwelling urinary catheterization. This clinical trial aimed to examine the efficacy of bladder irrigation with normal saline solution in preventing CAUTI in comatose patients admitted to intensive care units.

MATERIALS AND METHODS

Eligible patients were randomized to the experimental group or control group. The experimental group received daily bladder irrigation with 450 cc sterile normal saline, in 3 150-mL doses, for 3 consecutive days. Data on signs of CAUTI, including urine culture, axillary body temperature (primary outcomes), and other urine and blood parameters (secondary outcomes) were obtained at baseline and 5 days later.

RESULTS

Results of group comparisons and logistic regression analysis that controlled for fluid intake showed that the risk of CAUTI decreased by 99% in the experimental group compared with the control group (odds ratio, 0.01; P < .001). Additional findings indicated a decrease in axillary body temperature and improvements in urine appearance, urinary red cells and white cells, and erythrocyte sedimentation rates and white-cell counts in the blood following bladder irrigation.

CONCLUSION

Daily bladder irrigation with normal saline during 3 days demonstrated efficacy in preventing CAUTI in comatose patients.

摘要

背景

膀胱冲洗可用于预防与导尿管相关的尿路感染(CAUTI),但在短期留置导尿管中尚未报道其疗效。本临床试验旨在研究生理盐水膀胱冲洗在预防 ICU 昏迷患者 CAUTI 中的疗效。

材料与方法

将符合条件的患者随机分为实验组或对照组。实验组每天接受 450cc 无菌生理盐水膀胱冲洗,分 3 次给予 150ml 剂量,连续 3 天。在基线和 5 天后,收集有关 CAUTI 迹象的尿液培养、腋体温(主要结局)和其他尿液和血液参数(次要结局)的数据。

结果

组间比较和控制液体摄入量的逻辑回归分析结果表明,与对照组相比,实验组的 CAUTI 风险降低了 99%(比值比,0.01;P<.001)。其他发现表明,膀胱冲洗后腋体温下降,尿液外观、尿液红细胞和白细胞、红细胞沉降率和血液白细胞计数改善。

结论

在 3 天内每天用生理盐水进行膀胱冲洗可有效预防昏迷患者的 CAUTI。

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