泌尿外科手术患儿导尿管相关尿路感染危险因素分析、预测模型构建及护理对策  

Analysis of Risk Factors of Catheter Related Urinary Tract Infection in Children Undergoing Urological Surgery,Construction of Predictive Model and Nursing Countermeasures

作　　者：彭丽红[1] PENG Li-hong(Hunan Children's Hospital,Changsha Hunan 410007)

机构地区：[1]湖南省儿童医院,湖南长沙410007

出　　处：《医学临床研究》2022年第12期1778-1781,共4页Journal of Clinical Research

摘　　要：【目的】探讨行泌尿外科手术治疗的患儿导尿管相关尿路感染的相关危险因素。【方法】选择2020年4月至2021年4月于本院泌尿外科行手术治疗且术后留置尿管的169例患儿,根据患儿术后是否发生尿路感染将其分为感染组(n=31)和未感染组(n=138)。收集两组患儿临床资料,对可能影响患儿术后尿路感染发生的各因素进行单因素及多因素回归分析,并构建其预测模型,采用受试者工作特征(ROC)曲线分析该预测模型对泌尿外科手术患儿术后尿导管相关尿路感染发生的预测价值。【结果】169例泌尿外科术后留置导尿管患儿中,术后发生导尿管相关尿路感染患儿31例(18.34%)。病原菌29株,其中革兰阴性菌18株(62.07%)、革兰阳性菌10株(34.48%)、真菌1株(3.45%)。单因素分析显示,两组患儿导尿管留置时间、既往导尿管留置史、住院时间以及导尿管更换次数比较,差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,导尿管留置时间、既往导尿管留置史、住院时间以及导尿管更换次数为影响患儿术后导尿管相关尿路感染的独立危险因素(P<0.05)。ROC曲线分析显示,预测模型曲线下面积为0.933(95%CI:0.875~0.991),具有较好的预测价值(P=0.000)。【结论】导尿管留置时间、既往导尿管留置史、住院时间以及导尿管更换次数是影响泌尿外科术后尿导管相关尿路感染发生的独立危险因素,预测模型对患儿尿路感染的发生具有良好的预测价值。【Objective】To investigate the risk factors of catheter associated urinary tract infection in children undergoing urological surgery.【Methods】A total of 169 children with urinary tract infection who underwent surgical treatment in the urology department of our hospital from April 2020 to April 2021 and had urinary catheters retained after surgery were divided into infection group(n=31)and non infection group(n=138)according to whether the children had urinary tract infection after surgery.The clinical data of two groups of children were collected,and single factor and multi factor regression analysis was conducted on the factors that may affect the occurrence of urinary tract infection in children after surgery,and a prediction model was constructed.The ROC curve was used to analyze the predictive value of the prediction model on the occurrence of urinary tract infection related to urinary catheters in children after urological surgery.【Results】Among 169 children with indwelling catheter after urological surgery,31(18.34%)had catheter related urinary tract infection.29 pathogens,including 18 gram-negative bacteria(62.07%),10 gram-positive bacteria(34.48%)and 1 fungus(3.45%).Univariate analysis showed that there was a significant difference between the two groups in terms of catheter retention time,previous catheter retention history,hospital stay and catheter replacement times(P<0.05).Multivariate logistic regression analysis showed that the indwelling time of urinary catheter,previous indwelling history of urinary catheter,hospitalization time and the number of catheter replacement were independent risk factors for postoperative urinary tract infection in children(P<0.05).The ROC curve analysis shows that the area under the curve of the prediction model is 0.933(95%CI:0.875~0.991),which has good prediction value(P=0.000).【Conclusion】The indwelling time of urinary catheter,the previous indwelling history of urinary catheter,the length of hospital stay and the number of catheter replacement are inde

关 键 词：导尿管插入术 泌尿道感染 泌尿外科手术 危险因素 

分 类 号：R726.913[医药卫生—儿科]