ICU尿路感染患者不同膀胱冲洗溶液及方式治疗效果比较  

Therapeutic effect comparison of different bladder irrigation solution and method on urinary tract infection for ICU patients

作　　者：陈晓华[1] 李武平[1] 刘冰[1] 王毓[2] 孙莉莉[3] 张晓娜[1] 

机构地区：[1]第四军医大学西京医院疾病预防控制科,陕西西安710032 [2]第四军医大学西京医院神经外科监护室,陕西西安710032 [3]第四军医大学西京医院神经内科监护室,陕西西安710032

出　　处：《护理学杂志》2016年第15期9-12,共4页Journal of Nursing Science

摘　　要：目的探讨不同膀胱冲洗溶液及方式对ICU留置尿管患者尿路感染的治疗效果,为治疗尿路感染提供参考。方法采用随机区组设计方案将120例ICU尿路感染患者分为A、B、C、D四组各30例,A组为压力式、0.02%呋喃西林/5%NaHCO_3溶液,B组为压力式、酸性氧化电位水(EOW),C组为重力式、0.02%呋喃西林/5%NaHCO_3溶液,D组为重力式、EOW。分别于冲洗后第3、7、10天采集尿培养标本,观察尿液性质变化。结果冲洗前后四组尿培养阳性率、菌落数、尿液浑浊率均存在显著差异,其中菌落数随冲洗天数的增加而逐渐降低(均P<0.05);A、D组的除菌效果优于C组,即压力组优于重力组、EOW组优于0.02%呋喃西林/5%NaHCO_3组(均P<0.05);B组尿培养阳性率、菌落数、尿浑浊率均低于C组(P<0.05,P<0.00714),尿培养阳性率从第7天开始出现显著差异(均P<0.05)。结论采用压力式膀胱冲洗或选择EOW作为冲洗溶液均可有效降低病原菌数量,两者联合可有效治疗尿路感染,冲洗大于7d效果更好。Objective To explore the therapeutic effect of different bladder irrigation solution and method on urinary tract infection for patients with indwelling catheter in ICU, and to provide reference for the treatment of urinary tract infection. Methods Totally 120 patients with urinary tract infection in ICU were randomized into group A, B, C and D using a crossover design,with 30 cases in each group. Group A received pressure dependent irrigation with 0.02% furacilin or 5% NaHCO3 solution, group B was given pressure dependent irrigation with electrolyzed oxidizing water （EOW）, group C received gravity-dependent irrigation with 0.02 furacilin or 5 % NaHCO3 solution, and group D was given gravity dependent irrigation with EOW. The urine samples were collected at 3,7 and 10 days after irregation, and the changes of urine properties were observed. Results There were significant differences in urine culture positive rate, colony count and urine turbidity rate before and after bladder irrigation for the 4 groups, and the colony count decreased gradually with the increase of the days of irrigation （P〈0.05 for all）. The sterilization effects of group A and D were better than that in group C, which means the pressure dependent group was better than gravity dependent group, and EOW group was better than 0.02 % furacilin or 50% NaHCO3 group （P〈0.05 for both）. The positive rate of urine culture, colony count and urine turbidity in group B were significantly lower than those in group C （P〈0.05 ,P〈0. 00714）, and it appeared significant differences in urine culture positive rate from the seventh day （P〈0.05 for both）. Conclusion Bladder irrigation using pressure dependent irrigation or choosing EOW as the washing solution could effectively decrease the number of pathogenic bacteria, combination of the irrigation solution and method could effectively treat urinary tract infection, and the therapeutic effect is better when irrigated more than 7 days.

关 键 词：尿路感染 压力式膀胱冲洗 重力式膀胱冲洗 酸性氧化电位水 0.02%呋喃西林/5%NaHCO_3溶液 治疗效果 

分 类 号：R472[医药卫生—护理学]