影响留置导尿管患者发生泌尿系统感染的多因素非条件Logistic回归分析  

Multivariate unconditional logistic regression analysis of urinary system infection in patients with indwelling catheters

作　　者：钱春艳 韩晓霞[1] 杨楠[1] Qian Chunyan;Han Xiaoxia;Yang Nan(Nursing Department,the Fifth Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第五附属医院护理部,郑州450052

出　　处：《保健医学研究与实践》2023年第2期76-80,共5页Health Medicine Research and Practice

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20190411)。

摘　　要：目的 探讨影响留置导尿管患者发生泌尿系统感染的多因素非条件Logistic回归,以期为临床治疗提供参考。方法选取2020年6月—2022年4月在郑州大学第五附属医院行留置导尿术的1 311例患者为研究对象。根据患者感染情况分为感染组(n=92)和未感染组(n=1 219)。采用多因素非条件Logistic回归分析导致留置导尿管后发生泌尿系统感染的危险因素。结果 1 311例患者中有92例(7.02%)在留置导尿管后发生泌尿系统感染,1 219例(92.98%)患者未出现感染。检出的病原菌中革兰阳性菌占25.00%、革兰阴性菌占44.56%、真菌占30.44%。多因素非条件Logistic回归分析结果显示,年龄≥75岁、住院时间≥15 d、肾功能异常、肿瘤、抗菌药物使用种类≥2种、侵入性操作、导尿管留置时间>5 d、白细胞计数≥2.0×109/L是导致留置导尿管患者发生泌尿系统感染的独立危险因素(P<0.05)。结论 年龄大、住院时间长、导尿管留置时间长、肾功能异常、合并肿瘤、抗菌药物滥用、侵入性操作多、白细胞升高是导致导尿管相关性泌尿系统感染发生的危险因素,临床上应严格掌握留置导尿管适应证,做好预防措施,以降低泌尿系统感染发生率。Objective This paper aims to investigate the multivariate unconditional logistic regression analysis of urinary system infection in patients undergoing indwelling urinary catheter,so as to provide evidence for clinical treatment.Methods From June 2020 to April 2022,1311 patients with indwelling catheters in the Fifth Affiliated Hospital of Zhengzhou University were selected as the study participants.They were assigned to the infected(n=92)and uninfected(n=1219)groups according to their infection.Multivariate unconditional logistic regression was used to analyze the risk factors causing urinary system infection after the indwelling catheter.Results Urinary system infection occurred in 92(7.02%)of 1,311 patients after indwelling catheter,and no infection occurred in 1219(92.98%)patients.Among the pathogens detected,25.00%were Gram-positive infections,44.56%Gram-negative bacteria,and 30.44%fungi.Multivariate unconditional logistic regression showed that age at 75 years or above,length of hospital stay no less than 15 days,abnormal renal function,tumors,type of antibacterial drug use no less than 2,invasive procedures,catheter indwelling time over 5 days,and white blood cell count of 2.0×109/L or above were independent risk factors for urinary system infection in patients with indwelling catheter(P<0.05).Conclusion Old age,long hospital stay,long indwelling time of urinary catheters,abnormal renal function,comorbid tumor,abuse of antibacterial drugs,multiple invasive procedures,and increased white blood cell count are risk factors for urinary system infection associated with urinary catheters.The indications of indwelling urinary catheters should be strictly grasped in clinical practice and preventive measures should be taken to reduce the incidence of urinary system infection.

关 键 词：导尿管 泌尿系统感染 危险因素 

分 类 号：R691.3[医药卫生—泌尿科学]