膀胱镜检查后患者发生尿路感染的危险因素分析

Analysis of risk factors in patients with urinary tract infection after cystoscopy

  • 摘要: 目的 探讨膀胱镜检查后患者发生尿路感染的危险因素,为有效控制患者发生尿路感染提供依据。方法 选取2014年7月-2015年6月在医院接受膀胱镜检查的患者96例,采用回顾性的分析方法分别统计患者的年龄、性别、有无合并症等,分析患者发生尿路感染的危险因素。结果 96例患者中有30例患者确诊为尿路感染,感染率为31.25%;检测出病原菌48株,其中以革兰阴性菌为主,共30株占62.50%,其次为革兰阳性菌16株占33.33%,真菌2株占4.17%;选取主要的革兰阴性菌、革兰阳性菌以及真菌进行药敏试验,结果显示其对大多数抗菌药物均产生一定耐药性;灌注次数≥6次、年龄≥65岁、有前列腺增生、留置导尿管以及糖尿病等基础疾病是膀胱镜检查后患者发生尿路感染的危险因素;在单因素分析的基础上,将有统计学意义的灌注次数、年龄、性别、糖尿病、前列腺增生以及留置导尿管等变量因素,采用logisctic进行回归分析,筛选出独立危险因素,按照OR值的大小,依次为年龄大、糖尿病、前列腺增生以及留置导尿管。结论 术前对前列腺增生及糖尿病等基础疾病患者进行治疗,严格控制留置导尿管的适用指征和无菌操作,有效减少患者尿路感染。

     

    Abstract: OBJECTIVE To explore the risk factors in patients with urinary tract infection after cystoscopy, so as to provide basis for effective control of urinary tract infection in patients with urinary tract infection. METHODS A total of 96 patients from Jul. 2014 to Jun. 2015 in our hospital after cystoscopy were selected as research subjects. The patient's age, gender, comorbidities, etc. were retrospectively analyzed, and the risk factors of urinary tract infection were analyzed. RESULTS Totally 30 patients were diagnosed with urinary tract infection in 96 patients, with the infection rate of 31.25%. Totally 48 pathogens were detected, including 30 strains of gram-negative bacteria as the main pathogens, accounting for 62.50%, followed by 16 strains of gram-positive bacteria, accounting for 33.33%, and 2 strains of fungi, accounting for 2, 4.17%. The drug sensitivity tests were carried out on three kinds of main pathogens, and the results showed that they had a certain drug resistance to most of the antibiotics. Perfusion more than 6 times, 65 years of age or older, prostate hyperplasia, indwelling catheter, and diabetes and other basic diseases were risk factors of urinary tract infection in patients after cystoscopy. On the basis of single factor analysis, the variables such as the number of perfusion, age, gender, diabetes, prostate hyperplasia and indwelling catheter were statistically analyzed using logistic regression analysis for screening out the independent risk factors. As a result, according to the OR value, they were followed by: age, diabetes, prostate hyperplasia and indwelling catheter. CONCLUSION Preoperative treatment of prostate hyperplasia and diabetes and other basic diseases, and strict control of indications for indwelling catheter and aseptic technique, can effectively reduce urinary tract infections in patients.

     

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