基于单中心护理经验的缺血性脑卒中患者导尿管相关尿路感染危险因素分析

IF 0.9 4区 医学 Q4 UROLOGY & NEPHROLOGY
Qiuling Li, Pu Yan
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引用次数: 0

摘要

目的:探讨缺血性脑卒中患者导管相关性尿路感染(CAUTI)的危险因素,为制定针对性的预防和护理措施提供科学依据。方法:对2023年12月至2025年2月首都医科大学附属北京天坛医院急诊科收治的缺血性脑卒中伴留置导管患者进行回顾性队列研究。住院期间,严格按照患者导尿管插入及日常导尿管维护的一致护理操作进行质量控制。根据病历系统记录的尿路感染发生情况,将患者分为感染组和非感染组。采用单因素和多因素logistic回归分析两组患者的一般情况及相关危险因素。结果:998例缺血性脑卒中患者住院并接受留置导尿护理。其中发生CAUTI 87例,发生率为8.72%。87例缺血性脑卒中并发CAUTI患者共检出病原菌376株。根据CAUTI的发生情况将患者分为感染组(n = 87)和非感染组(n = 911)。Logistic回归分析显示:年龄≥60岁(优势比(OR) = 0.525, 95%可信区间(CI) = 0.314 ~ 0.877)、体重指数(BMI)≥28.1 kg/m2 (OR = 3.219, 95% CI = 1.446 ~ 5.630)、糖尿病(OR = 2.901, 95% CI = 2.238 ~ 3.386)、肠外营养支持(OR = 2.943, 95% CI = 2.113 ~ 3.223)、留置导尿时间≥6天(OR = 0.689, 95% CI = 0.193 ~ 0.985)、留置导尿次数≥2次(OR = 1.733、95% CI = 0.345 ~ 3.513)和使用抗微生物药物时间≥7天(OR = 0.756, 95% CI = 0.418 ~ 1.356)均是缺血性脑卒中患者发生CAUTI的危险因素(p < 0.05)。结论:年龄、BMI、糖尿病、肠外营养支持、留置尿管时间、插管次数、抗菌药物使用时间是缺血性脑卒中患者发生CAUTI的危险因素。可采取考虑到这些风险因素的预防措施和护理战略,以减少感染风险。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Analysis of Risk Factors for Urinary Catheter-Associated Urinary Tract Infection in Patients with Ischaemic Stroke Based on a Single-Centre Nursing Experience.

Objective: This study aimed to investigate the risk factors for catheter-associated urinary tract infection (CAUTI) in patients with ischaemic stroke and provide a scientific basis for developing targeted preventive and nursing measures.

Methods: A retrospective cohort study was conducted to study patients with ischaemic stroke and indwelling catheterisation admitted to the Emergency Department of Beijing Tiantan Hospital, Capital Medical University from December 2023 to February 2025. During hospitalisation, quality control was carried out in strict accordance with the consistent nursing operation of the patient's urethral catheter insertion and daily maintenance of the urinary catheter. According to the occurrence of urinary tract infection recorded by the medical record system, the patients were divided into infected group and non-infected group. Univariate and multivariate logistic regression analyses were conducted to examine the general information and relevant risk factors of the two patient groups.

Results: A total of 998 patients with ischaemic stroke were hospitalised and received indwelling urinary catheter care. Among them, 87 patients developed CAUTI, yielding an incidence rate of 8.72%. A total of 376 pathogenic bacteria were identified from the 87 patients with ischaemic stroke who developed CAUTI. The patients were divided into an infected group (n = 87) and a non-infected group (n = 911) according to the occurrence of CAUTI. Logistic regression analysis revealed that age ≥60 years (odds ratio (OR) = 0.525, 95% confidence interval (CI) = 0.314-0.877), body mass index (BMI) ≥28.1 kg/m2 (OR = 3.219, 95% CI = 1.446-5.630), diabetes (OR = 2.901, 95% CI = 2.238-3.386), parenteral nutrition support (OR = 2.943, 95% CI = 2.113-3.223), indwelling urinary catheter time ≥6 days (OR = 0.689, 95% CI = 0.193-0.985), number of catheter intubations ≥2 times (OR = 1.733, 95% CI = 0.345-3.513) and time to use antimicrobials ≥7 days (OR = 0.756, 95% CI = 0.418-1.356) were all risk factors for the development of CAUTI in patients with ischaemic stroke (p < 0.05).

Conclusions: Age, BMI, diabetes mellitus, parenteral nutrition support, time of indwelling urinary catheter, number of catheter intubations and time of antimicrobial use are the risk factors for CAUTI in patients with ischaemic stroke. Preventive measures and care strategies considering these risk factors can be taken to reduce the risk of infection.

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来源期刊
Archivos Espanoles De Urologia
Archivos Espanoles De Urologia UROLOGY & NEPHROLOGY-
CiteScore
0.90
自引率
0.00%
发文量
111
期刊介绍: Archivos Españoles de Urología published since 1944, is an international peer review, susbscription Journal on Urology with original and review articles on different subjets in Urology: oncology, endourology, laparoscopic, andrology, lithiasis, pediatrics , urodynamics,... Case Report are also admitted.
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