导尿管伴随性尿路感染的预防

导尿管伴随性尿路感染(UTIc)是一种常见的院内感染，约占医院内感染的40％左右。多年来为预防UTIc的发生，人们从抗生素、导管材料、导管的留置及引流方式等多方面进行研究，但长期导尿病人仍将100％发生尿路感染。本文对72例长期留置导尿管病人尿路感染的防治措施进行了观察，探讨导尿管伴随性尿路感染的发生、发展规律及防治措施。     

肝素灌注预防导尿管伴随性尿路感染

导尿管伴随性尿路感染(ＵＴＩＣ)是一种常见的院内感染。我们对162例留置导尿管患者进行观察,探讨ＵＴＩＣ的发生、发展规律及预防措施。1　资料与方法11　一般资料:本组因脑出血、脑梗死、格林-巴利综合征等疾病需要留置导尿管患者162例,男95例,女67例;年龄24～75岁,平均年龄51岁。插管前尿细菌培养均阴性,按所用膀胱冲洗液不同随机分成2组进行观察,对照组(呋喃西林组)80例予留置导尿管之日起,用1∶5000的呋喃西林溶液200ｍｌ常规冲洗膀胱每日2次;观察组(肝素组)82例予留置导尿管之日起,用肝素钠注射液1875国际单位(15ｍｇ)加入09%氯化钠注…     

外用碘预防导尿管伴随性尿路感染

根据流行病学调查，导尿管相关的泌尿系统感染发生率为92％-93％，约占院内感染的40％。留置导尿是临床上常用的一种治疗性操作技术，不仅是观察病情的需要，也是治疗某些疾病的主要措施。有资料表明导尿患者菌血症的发生率是未导尿患者的5．8倍，其危害性随保留导尿管的时间而增加。作者对76例留置导尿管患者随机分成常规组和碘剂组，通过对拔前中段尿、导尿管、拔管后24h后中段尿，作细菌学检测分析，观察导尿管伴随性尿路感染（UTIC）的发生及局部应用碘剂对UTIC的预防作用，现报告如下。     

八正散预防导尿管伴随性尿路感染的临床研究

目的研究八正散煎剂口服防治导尿管伴随性尿路感染的临床疗效.方法将入选病例110例随机分为治疗组58例,对照组52例.对照组予以常规护理及全身和局部应用抗生素;治疗组在对照组基础上予以八正散煎剂内服.两组均隔日按无菌操作收集尿液作细菌培养.结果治疗组尿细菌培养阳性明显低于对照组(p＜0.05).结论八正散煎剂能抑制大肠杆菌菌毛表达和对尿道上皮细胞粘附作用,配合尿道口消毒,有效地预防了导尿管伴随性尿路感染.     

气囊导尿管伴随性尿路感染的预防及护理

目的探讨气囊导尿管伴随性尿路感染（UTIC）的预防及护理方法2004年5月至2005年8月，留置气囊导尿管病人56例，随机分成两组，对照组28例，用1：5000呋喃西林溶液250ml冲洗膀胱，一天二次；观察组28例。用肝素钠15mg加入250ml生理盐水中与1：5000呋喃西林溶液交替冲洗膀胱，每天一次。72小时后进行尿细菌培养，细菌数〉105／ml为尿路感染。结果对照组尿菌阳性率39．3％（11／28），观察组10．7％（3／28），Xc2—4．19，P〈0．05，两组比较差异有统计学意义。结论UTIC的发生与膀胱冲洗液的选择及导尿管留置时间有明显关联，规范相关护理措施能有效预防UTIC发生。     

导尿管伴随性尿路感染及其护理

为探讨导尿管伴随性尿路感染有效护理的途径和对策,对４８ 例留置导尿管患者随机分组进行观察。具体方法是隔日收集尿液送细菌培养,当尿培养细菌数＞ １０５／ｍｌ 时定为尿路感染。结果３ 组患者随插管时间的延长,尿培养细菌阳性率逐日增加,３ 组间相应天数的细菌感染率有显著性差异（ Ｐ＜ ０ ．０５） 。认为在密闭式引流的基础上,全身应用有效抗生素配合０ ．１ ％ 新洁尔灭定时冲洗导尿管并清除尿道口分泌物,可延缓导尿管伴随性尿路感染的发生,对短期留置导尿管的患者效果明显,但对长期留置导尿管而发生感染的患者仍难以奏效。     

导尿管伴随尿路感染及其护理

近几年来我科有百余例患者使用双腔气囊导尿管，在使用过程中存在着若干问题我们对这些问题有针对性的进行分析并采取了相应的护理措施，收到了较好的效果。     

导尿管改良固定法在预防导管伴随性尿路感染中的作用

留置导尿是临床常用的诊疗技术,是治疗排尿困难、观察尿量的基本手段。但导尿引起的导管伴随性尿路感染(catheter-associated urinary tract infection,CAUTI)长期以来一直困扰着医护人员,每天约有5%的带管患者发生菌尿[1]。为探讨降低CAUTI发生的相关因素,我院在导管的固定方法上做了积极探索,运用“高举平台”改良导尿管固定法,取得了一定效果,现报道如下。1对象与方法1.1对象选取2005年4月~2006年4月住院且行留置导尿术的患者100例,其中男58例,女42例,年龄26岁~92岁,平均年龄53.5岁。留置导尿的原因:手术需要56例,尿失禁23例,观察尿…     

上尿路结石感染的病原学特征及即刻引流效果分析

目的 观察上尿路结石感染的病原学特征及术后即刻引流的治疗效果。方法 回顾性分析100例上尿路结石感染患者的临床资料,调查患者病原菌感染类型并针对常见菌属进行药敏试验分析,患者手术后均接受即刻引流,观察即刻引流的治疗效果。结果 100例上尿路结石感染患者中,58.00%为革兰阴性菌感染,31.00%为革兰阳性菌感染,11.00%为真菌感染。药敏试验结果显示,大肠埃希菌对氨苄西林、头孢唑啉、头孢曲松和诺氟沙星耐药性较高,对头孢哌酮舒巴坦、阿米卡星敏感性较高;粪肠球菌对庆大霉素、青霉素G和红霉素耐药性较高,对万古霉素、替考拉宁和氨苄西林敏感性较高。100例患者均顺利完成手术,引流后均未发生感染性休克、败血症和大出血等并发症;治疗后1、2、3 d,患者体温、白细胞、中性粒细胞百分比、C反应蛋白、降钙素原和白细胞介素-6水平低于治疗前,差异有统计学意义(P<0.05)。结论 上尿路结石感染患者的病原菌以革兰阴性菌为主,术后即刻引流能尽快控制感染,减少败血症、感染性休克等并发症的发生。     

Pediatric urinary tract infection

UTIs are common in children. They may present with a range of severity from cystitis to febrile UTI or pyelonephritis. The presentation may be vague and have nonspecific symptoms. Therefore, a UTI should be considered in all children with a fever in whom other sources have been excluded. Treatment depends on the age, location of infection, and degree of illness in the child. Sick children and infants less than 3 months should be treated as inpatients, and healthy children and older infants may be treated as outpatients. Urinalysis provides presumptive evidence of infection, whereas urine culture is definitive. Close follow-up and outpatient evaluations are needed to prevent long-term consequences of infection.     

Hospital-acquired urinary tract infection

Nosocomial urinary tract infections (UTIs) account for up to 40% of all hospital-acquired infections. The associated morbidity and mortality are a major drain on hospital resources. Patients with indwelling urinary catheters, patients undergoing urological manipulations, long-stay elderly male patients and patients with debilitating diseases are at high risk of developing nosocomial UTIs. The organisms responsible usually originate from patients' endogenous intestinal flora, but occasionally from a moist site in the hospital environment. Nosocomial pathogens causing UTIs tend to have a higher antibiotic resistance than simple UTIs. Infection control policies are important in limiting the number of hospital-acquired UTIs. Other important points include catheterisation using an aseptic technique and sterile equipment and the use of closed drainage systems. UTIs should be treated only after a urine sample has been sent and the advice of a microbiologist sought. In the future catheters impregnated with antibiotics, and the use of newer materials, may lead to further reductions in the incidence of nosocomial UTIs.     

Catheter-associated urinary tract infection

This guideline contains updated recommendations on the management and prevention of CAUTIs by the Urological Association of Asia and the Asian Association of Urinary Tract Infection and Sexually Transmitted Infection.     

Female urinary tract infection

Changing concepts regarding the epidemiology, pathogenesis, evaluation, and treatment of urinary tract infection have reduced patient expenditures. An appreciation of the natural history and associated significance of these infections at all ages in both male and female patients is essential for proper evaluation and treatment. Careful classification of the infection with attention to historical aspects allows the clinician to plan a treatment regimen tailored to each patient. When and how these patients are evaluated depend on the statistical likelihood of associated pathology.     

The prevalence of urinary tract infection in patients related to type of drainage bag

The prevalence of urinary tract infection in patients catheterised inside the hospital was studied in relation to the type of drainage bag used. Five hundred and thirty-two adult patients of both sexes were studied in three groups consisting of (1) open drainage system with an infection incidence of 38.9%; (2) closed system with 25.1%; and (3) the closed system plus the addition of chlorhexidine with 15% infection. The overall incidence of infection was 29.8%. There was a statistically significant difference between the first and the second group (p less than 0.01), the first and the third group (p less than 0.01), but none between the second and third groups (p greater than 0.01). The incidence was higher in women than in men (p less than 0.01), but only in the age group greater than or equal to 60 (p less than 0.01). The index of medical patients was significantly higher than in urological patients (p less than 0.05), while there was no statistical significance between surgical and urological patients (p greater than 0.1). The highest prevalence of infection in the three groups occurred on the seventh day. Gram-negative bacteria were 63.3%, Gram-positive 10.1% and fungi 26.6%.     

上尿路手术病人留置双J管引流的护理

笔报道上尿路结石、狭窄、损伤、肿瘤侵犯切除等于术后病人，放置输尿管内引流管(双J管)的护理。针对放置双J管后可能出现的并发症，进行观察和护理。护理要点是对尿液颜色和尿量的观察；预防尿路刺激症状和尿液返流的护理：加强住院期间的健康教育和出院病人跟踪服务(电话随访)，提高病人复诊率，减少术后并发症的发生．使双J管起到引流尿液、缓解梗阻，防止疤痕狭窄、输尿管损伤的搭桥作用，提高了手术成功率。