尿管置管循证护理对脊髓损伤留置导尿管患者尿路感染影响的研究  

Effect of evidence-based nursing of catheterization on urinary tract infection in patients with spinal cord injury and catheterization

作　　者：王文丽[1] 朱政 陈学樊[1] 彭双[1] 谭晓菊[1] WANG Wenli;ZHU Zheng;CHEN Xuefan;PENG Shuang;TAN Xiaoju(Department of Spinal Surgery,the Second Xiangya Hospital of Central South University,Changsha,Hunan 410011,P.R.China)

机构地区：[1]中南大学湘雅二医院脊柱外科,长沙410011

出　　处：《华西医学》2020年第10期1181-1184,共4页West China Medical Journal

基　　金：中南大学湘雅二医院2018年护理科研立项项目(2018-YHL-49)。

摘　　要：目的探讨尿管置管循证护理对脊髓损伤长期留置导尿管患者尿管置管相关性尿道损伤及尿路感染发生率的影响。方法选择2017年7月1日—2018年11月30日脊柱外科脊髓损伤留置导尿管患者100例作为研究对象进行前瞻性研究,按照入院时间先后分组,2017年7月—2018年2月入院的患者为对照组(n=50),2018年3月—11月入院的患者为观察组(n=50)。对照组采用传统尿管置管方式进行尿管置管,观察组采用尿管置管循证护理方式进行尿管置管。比较两组患者尿管置管后导尿管相关尿道损伤及尿路感染发生率。结果对照组与观察组患者性别、年龄、诊断、住院时间差异均无统计学意义(P>0.05),住院期间分别共置管57次和59次。对照组患者尿管置管后尿道口出血及肉眼血尿的发生率分别为22.80%(13/57)和15.78%(9/57),观察组患者尿道口出血、肉眼血尿的发生率均为1.69%(1/59),两组比较差异有统计学意义(P<0.05);对照组尿路感染发生率为42.0%(21/50),观察组为18.0%(9/50),两组比较差异有统计学意义(P=0.009)。结论脊髓损伤长期留置导尿管患者基于循证的尿管置管护理可以有效预防置管相关性尿道损伤的发生,降低患者住院期间导尿管相关尿路感染发生率,提高临床护理质量。Objective To explore the influence of evidence-based nursing care of catheterization on the incidence of urinary tract injury and urinary tract infection in patients with spinal cord injury and long-term indwelling catheters.Methods From July 1st,2017 to November 30th,2018,100 patients with spinal cord injury indwelling catheters in Department of Spinal Surgery were prospectively selected as the research objects.According to the admission time,patients admitted between July 2017 and February 2018 were assigned into the control group(n=50),and patients admitted between March 2018 and November 2018 were assigned into the observation group(n=50).Traditional catheter placement was used in the control group,while evidence-based catheter placement was used in the observation group.The incidences of catheter-related urethral injury and urinary tract infection after the catheterization were compared between the two groups.Results There was no statistically significant difference in gender,age,diagnosis,or length of hospital stay between the two groups(P>0.05).Catheter placement was performed 57 times in the control group and 59 times in the observation group during hospitalization.After catheterization,the incidences of urethral hemorrhage and gross hematuria in the control group[22.80%(13/57)and 15.78%(9/57),respectively]were higher than those in the observation group[both were 1.69%(1/59)],with statistical differences between the two groups(P<0.05).The incidence of urinary tract infection in the control group differed from that in the observation group[42.0%(21/50)vs.18.0%(9/50),P=0.009].Conclusion The evidence-based urinary catheterization method for patients with spinal cord injury and long-term indwelling catheter can effectively prevent catheter-related urinary tract injury,reduce the incidence of catheter-related urinary tract infection during hospitalization,and improve the quality of clinical care.

关 键 词：脊髓损伤 长期留置导管 尿管置管 尿路损伤 尿路感染 

分 类 号：R-03[医药卫生] R473.6