盲升结肠可控膀胱术后上尿路感染危险因素多元分析  

Multiple Risk Factors for Upper Urinary Tract Infection in Patients after Detenia Ceacal Colon Continent Reservoir Operation

作　　者：左翼[1] 游杰[1] 唐培 李新民 

机构地区：[1]广州市第一军医大学附属南方医院泌尿外科,510515

出　　处：《中华护理杂志》2000年第12期709-711,共3页Chinese Journal of Nursing

摘　　要：目的 :建立多元回归方程 ,了解根治性膀胱全切、去带盲升结肠储尿囊、阑尾或回肠输出道可控膀胱术后上尿路感染的发病因素。方法 :通过对医院 1995～ 1998年行根治性膀胱全切去带盲升结肠储尿囊可控膀胱术患者的问卷式随访 ,多因素逐步回归分析尿流改道后上尿路感染的发病危险因素。结果 :门坎值F =3.84,引入变量 ,回归方程 :0 .6 32 +0 .40 5X2 1- 0 .0 94X11- 0 .5 2X19+0 .2 44X7- 0 .15 4X9。结论 :膀胱全切盲升结肠储尿囊尿流改道后 ,肾盂和 (或 )输尿管积水、自主生活能力下降、日间导尿间歇过长易引起上尿路感染 ,而定期的储尿囊冲洗及导尿管消毒对上尿路具有保护性作用。Objective:To identify the risk factors resulting in upper urinary tract infection after radical cystectomy,urinary diversion and detnia ceacal colon continent reservoir operation by establishing a multiple factor regression equation to decrease the incidence of upper urinary tract infection.Methods 31 patients who underwent radical cystectomy and detenia ceacal colon continent reservoir operation in Nanfang hospital during 1995 to 1998 were investigated by questionnaire recently.The risk factors of upper urinary tract infection postoperatively were also analyzed by multiple factor stepwise regression analysis.Results:A regression equation was established as follows:Y=0.632+0.405X 1(hydronephrosis)-0.094X 2(sterilizing of reservoir)-0.52X 3(viability)+0.244X 4(interval of daily catheterization)-0.154X 5(sterilizing of urethral catheter).The threshold F=3.84 was introduced into the equation.Conclusion Incidence of upper urinary tract infection was significantly increased in postoperative cases following radical cystecotomy and urinary diversion due to bladder and prostatic malignant disease,which lost the normal antibacterial defensive barrier in the urinary tract ,as a result urinary tract could be invaded easily.Urinary tract infection had become the primary factor that inflicated doctors and patients,decreased patients' living quality and even incapacitating patients after detenia ceacal colon continent reservoir operation.This study showed that hydroureteronephrosis,disablement and long interval catheterization at daytime resulted in upper urinary infection,very easily while pertadic rinsing of urine reservoir and sterilizing of urethral catheter took protective effects on upper urinary tract.

关 键 词：膀胱肿瘤 上尿路感染 危险因素 外科手术 

分 类 号：R737.140.5[医药卫生—肿瘤] R473.6[医药卫生—临床医学]