输尿管皮肤造口患者尿路感染的危险因素分析及预防对策  

Analysis of risk factors and preventive measures for urinary tract infection in patients of ureterocutaneostomy

作　　者：王双凤[1] 刘会范[1] 左书强[1] 齐艳[1] 李文清[1] 苏明阳[1] WANG Shuang-feng;LIU Hui-fan;ZUO Shu-qiang;QI Yan;LI Wen-qing;SU Ming-yang(The First Affiliated Hospital of Zhengzhou University,Zhengzhou Henan 450052,China)

机构地区：[1]郑州大学第一附属医院,河南郑州450052

出　　处：《中国消毒学杂志》2018年第11期853-855,共3页Chinese Journal of Disinfection

摘　　要：目的分析输尿管皮肤造口术后尿路感染的病原菌分布及相关危险因素,为临床预防及治疗提供参考。方法回顾性分析某医院泌尿外科行输尿管皮肤造口术患者的临床资料,对其尿路感染的相关危险因素进行单因素和多因素Logistic回归分析。结果本研究98例患者中发生尿路感染患者共28例,尿路感染发生率为28. 57%,共分离出病原菌42株,其中革兰阴性菌占73. 81%,革兰阳性菌占21. 43%,真菌占4. 76%;多因素Logistic回归分析结果显示,患者年龄≥60岁、输尿管支架管留置时间≥3个月、尿液引流不畅、造口周围并发症和合并糖尿病为患者术后发生尿路感染的独立危险因素。结论输尿管皮肤造口患者术后发生尿路感染与患者合并基础疾病、支架管留置时间过长及尿液引流不畅有关。采取定期更换输尿管支架管并保持支架管通畅、减少造口周围并发症的发生、增加每日饮水摄入量、有效控制糖尿病等措施可有效预防输尿管皮肤造口术后尿路感染的发生。Objective To analyze the distribution of pathogenic bacteria and related risk factors of urinary tract infection after ureterocutaneostomy,and to provide reference for clinical prevention and treatment. Methods Retrospective analysis the clinical data of 98 patients who underwent ureterocutaneostomy in the Urology Surgery of the Hospital were retrospectively analyzed. The risk factors of urinary tract infection were analyzed by univariate and multivariate Logistic regression analysis. Results Among the 98 patients,28 cases had urinary tract infection. The incidence of urinary tract infection was28. 57%,and 42 strains were isolated. Among them,gram-negative bacteria accounted for 73. 81%,Gram-positive bacteria accounted for 21. 43%,fungi accounted for 4. 76%. Multivariate Logistic regression analysis showed that patients aged 60 or above,ureteral stent replacement time ≥ 3 months,urine drainage obstructed,diabetes were independent risk factors of urinary tract infection for patients after surgery. Conclusion Urinary tract infection after ureterostomy is associated with underlying disease,prolonged stent retention,and poor urinary drainage. The ureteral stent should be replaced regularly to keep the stent free and reduce the occurrence of complications around the stoma,Increasing daily water intake.reducing urostomy complications,effective control of diabetes can effectively prevent urinary tract infection after ureterocutaneostomy.

关 键 词：输尿管皮肤造口术 尿路感染 危险因素 

分 类 号：R693[医药卫生—泌尿科学]