集束化护理对预防脊柱骨折患者围手术期导尿管相关泌尿系感染的效果研究  

Effect of clustering nursing on the prevention of urinary tract infection associated with urinary catheter in patients with spinal fracture during perioperative period

作　　者：陈巧灵 马燕兰[1] 唐家广[1] 周体[1] 李侗侗 Chen Qiaoling;Ma Yanlan;Tang Jiaguang;Zhou Ti;Li Tongtong(Department of Orthopaedics,General Hospital of Chinese People's liberation Army,Beijing 100044,China)

机构地区：[1]解放军总医院骨科医学部,北京100044

出　　处：《中国实用护理杂志》2021年第34期2673-2679,共7页Chinese Journal of Practical Nursing

基　　金：北京市科技计划(D161100002816003)。

摘　　要：目的探讨集束化护理干预对预防脊柱骨折患者围手术期导尿管相关泌尿系感染(CAUTI)的临床效果。方法采用回顾性病例对照方法,选取解放军总医院骨科医学部急诊收治住院的脊柱骨折患者160例,其中2018年1—12月收治住院的80例患者为对照组,2019年1月至2020年3月收治住院的80例患者为观察组。对照组患者给予常规护理措施,观察组患者在常规护理的基础上实施集束化护理干预,比较2组患者导尿管留置时间、导尿管复插的发生率及CAUTI发病率。结果观察组导尿管留置时间为(3.37±0.64)d,对照组为(6.35±1.52)d,2组比较差异有统计学意义(t值为-16.16,P<0.05);观察组的导尿管复插发生率、CAUTI发病率分别为5.00%(4/80)、3.80%(3/80),低于对照组的11.30%(9/80)、16.30%(13/80),2组比较差异有统计学意义(χ^(2)值为-2.927、-2.654,均P<0.05)。结论对脊柱骨折患者在围手术期实施集束化护理干预可有效缩短导尿管留置时间,降低导尿管复插的发生率和患者CAUTI的发病率,对患者的治疗、康复均具有积极意义。Objective To investigate the clinical effect of cluster nursing on the prevention of perioperative urinary catheter associated urinary tract infection(CAUTI)in patients with spinal fracture.Methods A retrospective case-control method was used to select 160 patients with spinal fracture admitted to the department of spinal cord injury in emergency care from January 2018 to March 2020 in the Department of Orthopaedics General Hospital of Chinese People's Liberation Army as study subjects,80 patients admitted to the department of spinal cord injury from January to December 2018 were set as the control group,and 80 patients admitted from January 2019 to March 2020 as the observation group.The control group was given standardized clinical nursing measures during the perioperative period,while the observation group was given cluster nursing measures.The duration of indwelling of catheters,the incidence of catheter reinsertion and the incidence of CAUTI were compared between the two groups.Results The catheter indwelling time in the observation group was(3.37±0.64)days,lower than that in the control group(6.35±1.52)days.The incidence of catheter insertion and CAUTT was 5.00%(4/80),3.80%(3/80)in the observation group,lower than 11.30%(9/80),11.60%(13/80)in the control group.The differences were statistically significant(χ^(2)values were-2.927,-2.654,all P<0.05).Conclusions Cluster nursing intervention for patients with spinal fracture in the perioperative period can effectively shorten the catheter indwelling time,reduce the incidence of catheter re-insertion and the incidence of patients with CAUTI,significantly improve the quality of clinical care in the department,and have positive significance for the treatment and rehabilitation of patients.

关 键 词：脊柱骨折 围手术期 集束化护理 导尿管相关泌尿系感染 

分 类 号：R473.6[医药卫生—护理学]