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逆行性上尿路碎石术后尿路感染的危险因素:对护理的启示。

Risk factors for urinary infection after retrograde upper urinary lithotripsy: Implication for nursing.

机构信息

Department of Urology, Wuhan Central Hospital, Wuhan, Hubei, China.

出版信息

Medicine (Baltimore). 2021 Aug 6;100(31):e26172. doi: 10.1097/MD.0000000000026172.

Abstract

There are needs to evaluate the risk factors for urinary infection after retrograde upper urinary lithotripsy, to provide insights into the management and nursing care of patients with retrograde upper urinary lithotripsy.Patients who received retrograde upper urinary lithotripsy with a Foley 20 urinary tube insertion from June 1, 2019 to December 31, 2020 in our hospital were selected. Patients were grouped urinary infection and no infection group according to the culture results of urine, and the clinical data of the 2 groups of patients were collected and compared. Single factor and logistic regression analysis were used to analyze the risk factors of urinary tract infection after retrograde upper urinary lithotripsy.Four hundred ten patients with retrograde upper urinary lithotripsy were included, of whom 62 patients had the urinary tract infection, the incidence of urinary tract infection was 15.12%. There were significant differences in the gender, age, diabetes, stone diameter, duration of urinary tube insertion and duration of surgery between infection and no-infection group (all P < .05). The Escherichia coli (62.90%) was the most commonly seen bacterial in patients with urinary tract infection. Female (odds ratio [OR]: 1.602, 95% confidence interval 95% [CI]: 1.132∼2.472), age >50 years (OR: 2.247, 95% CI: 1.346∼3.244), diabetes (OR: 2.228, 95% CI: 1.033∼3.451), stone diameter ≥2 cm (OR: 2.152, 95% CI: 1.395∼3.099), duration of urinary tube insertion ≥3 days (OR: 1.942, 95% CI:1.158∼2.632), duration of surgery ≥90 minutes (OR: 2.128, 95% CI: 1.104∼3.846) were the independent risk factors for the postoperative urinary tract infection in patients with retrograde upper urinary lithotripsy (all P < .05).The incidence of urinary tract infection in patients undergoing retrograde upper urinary lithotripsy was high, counteractive measures targeted on those risk factors are needed to prevent and reduce the postoperative urinary infection in clinical settings.

摘要

需要评估逆行上尿路碎石术后尿路感染的危险因素,为逆行上尿路碎石术患者的管理和护理提供思路。

选取 2019 年 6 月 1 日至 2020 年 12 月 31 日在我院行逆行上尿路碎石术并留置 Foley 20 导尿管的患者。根据尿液培养结果将患者分为尿路感染组和无感染组,收集并比较两组患者的临床资料。采用单因素和 logistic 回归分析逆行上尿路碎石术后尿路感染的危险因素。

共纳入 410 例行逆行上尿路碎石术患者,其中 62 例发生尿路感染,尿路感染发生率为 15.12%。感染组与无感染组患者的性别、年龄、糖尿病、结石直径、导尿管留置时间、手术时间比较,差异均有统计学意义(均 P<0.05)。尿路感染患者中最常见的细菌为大肠埃希菌(62.90%)。女性(比值比[OR]:1.602,95%置信区间 95%[CI]:1.132∼2.472)、年龄>50 岁(OR:2.247,95% CI:1.346∼3.244)、糖尿病(OR:2.228,95% CI:1.033∼3.451)、结石直径≥2 cm(OR:2.152,95% CI:1.395∼3.099)、导尿管留置时间≥3 d(OR:1.942,95% CI:1.158∼2.632)、手术时间≥90 min(OR:2.128,95% CI:1.104∼3.846)是逆行上尿路碎石术后尿路感染的独立危险因素(均 P<0.05)。

逆行上尿路碎石术患者术后尿路感染发生率较高,临床应针对这些危险因素采取针对性的预防措施,以降低术后尿路感染的发生。

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