导管相关性尿路感染危险因素分析及干预效果研究

摘要

Objective:To investigate the current status of catheter associated urinary tract infection (CAUTI)in a hospital,analyze the risk factors and provide scientific evidence for the effective control of CAUTI.Methods:557 patients with indwelling urethral catheterization in a hospital in April 2014 to December were targeted mo-nitoring,the status and risk factors of CAUTI were analyzed,and intervention measures were begun to imple-ment in January 2015.The infection rate before and after the intervention was compared and the effectiveness of intervention was evaluated.Results:Univariate analysis showed that there were six variables of CAUTI risk fac-tors.Logistic regression analysis was used to screen the independent risk factor as followed:indwelling catheter time≥20 days,fecal incontinence,diabetes,ICU length of stay≥20 days,and protective factors is the 24 hours urine volume≥3 000 mL.The infection rate were 35.37% and 20.44% before and after the intervention,the difference was statistically significant (P<0.05).Conclusion:There is a higher incidence of CAUTI and more risk factors in the hospital.Take targeted intervention measures can effectively control CAUTI.%[目的]调查某三级甲等医院导管相关性尿路感染(CAUTI)现况,分析危险因素并干预,为有效控制 CAUTI 提供依据。[方法]对某三级甲等医院2014年4月—2014年12月557例留置导尿病人进行目标性监测,分析 CAUTI 现况及危险因素并于2015年1月开始干预,对比干预前后感染率,评价干预效果。[结果]单因素分析显示有住院时间、入住重症监护室(ICU)时间、留置尿管时间、24 h尿量、合并糖尿病、大便失禁6个变量与CAUTI明显相关,多因素分析筛选出独立危险因素,依次为留置尿管时间≥20 d、大便失禁、糖尿病、入住 ICU时间≥20 d,保护因素为24 h尿量≥3000 mL；干预前感染率35.37%,干预后20.44%,差异有统计学意义(P<0.05)。[结论]该三级甲等医院CAUTI发生率较高,危险因素较多,采取针对性干预措施可有效控制CAUTI。