前列腺癌根治术后并发尿路感染的危险因素及PDCA护理策略分析  

Risk factors of urinary tract infections after radical prostatectomy for prostate cancer and PDCA nursing strategy analysis

作　　者：王海艳 洪丽娟 王声兴[1] 许思怡[1] 梁培育[1] WANG Haiyan;HONG Lijuan;WANG Shengxing;XU Siyi;LIANG Peiyu(Hospital Infection Management Department of the First Afiliated Hospital of Hainan Medical University,Haikou,Hainan 570102,China)

机构地区：[1]海南医学院第一附属医院医院感染管理科,海南海口570102

出　　处：《中华全科医学》2023年第9期1621-1624,共4页Chinese Journal of General Practice

基　　金：海南省科技厅重点研发计划项目(ZDYF2019122)。

摘　　要：目的 基于logistic回归模型研究前列腺癌根治术(RP)术后并发尿路感染的危险因素及计划-执行-检查-处理(PDCA)循环管理模式的护理策略,为RP患者术后护理提供参考。方法 选取2019年4月—2023年1月于海南医学院第一附属医院行RP手术治疗的284例前列腺癌患者为研究对象,采用随机数字表法将其分为对照组和观察组,各142例。术后对照组接受常规护理,观察组加用PDCA护理模式,比较2组术后尿路感染的发生情况,分析RP术后发生尿路感染的影响因素。结果 与对照组比较,观察组干预措施执行率较高(均P<0.05),尿路感染发生率较低[2.82%(4/142)vs.13.38%(19/142),P<0.05]。单因素分析和多因素logistic回归分析发现,年龄(≥65岁)、合并糖尿病、手术时间(≥90 min)、术后尿导管留置时间(≥5 d)是RP患者术后并发尿路感染的独立危险因素,护理方案(PDCA循环管理)是RP术后并发尿路感染的保护因素。结论 护理方案(PDCA循环管理)为前列腺癌根治术后并发尿路感染的保护因素,将PDCA循环管理模式应用于RP患者有助于提升护理措施执行力,降低术后尿路感染风险。Objective To investigate the risk factors of urinary tract infections after radical prostatectomy(RP)and the nursing strategy of the plan-do-check-act(PDCA)cycle management model based on the logistic regression model,and provide reference for postoperative care of RP patients.Methods A total of 284 patients with prostate cancer who underwent RP surgery in the First Affiliated Hospital of Hainan Medical University from April 2019 to January 2023 were selected as the study subjects.They were randomly divided into control group and observation group by using radom number table method with 142 cases each.The control group received routine nursing after surgery,while the observation group received PDCA nursing mode on the basis on control group.The incidence of postoperative urinary tract infections between the two groups was compared,and the influencing factors of urinary tract infections after RP surgery were analyzed.Results Compared to the control group,the observation group had a higher implementation rate of intervention measures(all P<0.05)and a lower incidence of urinary tract infections[2.82%(4/142)us.13.38%(19/142),P<0.05].Univariate analysis and multivariate logistic regression analysis showed that age(≥65 years old),combined with diabetes,operation time(≥90 min),and postoperative catheter retention time(≥5 days)were independent risk factors for postoperative urinary tract infection in RP patients,and nursing program(PDCA circulation management)was the protective factor for postoperative urinary tract infection in RP patients.Conclusion The nursing plan(PDCA cycle management)is a protective factor for postoperative urinary tract infections in patients with prostate cancer undergoing radical surgery.Applying PDCA cycle management mode to RP patients can help improve the execution of nursing measures and reduce the risk of postoperative urinary tract infections.

关 键 词：前列腺癌根治术 PDCA护理 尿路感染 危险因素 前列腺癌 

分 类 号：R473.6[医药卫生—护理学] R737.25[医药卫生—临床医学]