留置导尿患者膀胱冲洗频率的研究

目的探讨长期留置导尿患者的膀胱冲洗问题。方法选择120例长期留置导尿患者分为四组，分别给予2次／d、1次／d、1次／周或特殊情况下冲洗及不冲洗4种冲洗方法。于留置导尿当天、5d．7d、10d、14d、21d及拔尿管前采集尿液标本进行病原学检查，比较各组泌尿系感染情况。结果不冲洗组泌尿系感染率（13．33％）与1次／周或特殊情况下冲洗组（13．33％）相近，但较2次／d组（56．67％）、1次／d组（36．67％）低，差异具有统计学意义（x^2=18．73，P〈0．01）。但是尿培养阳性率比较中不冲洗组（20．00％）均低于1次／周或特殊情况下冲洗组（30．00％）、1次／d组（53．33％）、2次／d组（76．67％），差异具有统计学意义（X^2=23．30，P〈0．01）。泌尿系感染的危险因素分析冲洗频率、尿管留置天数是泌尿系感染的重要危险因素。结论频繁的膀胱冲洗不能预防泌尿系感染的发生，应根据患者情况采取个性化膀胱冲洗方案。

Study on the bladder irrigation of patients with indwelling urethral catheter

Objective To investigate the necessity of bladder irrigation of patients with long-term indwelling urethral catheter.Methods 120 patients with long-term indwelling urethral catheter were randomly divided into four groups and given bladder irrigation in different frequency(2/d,1/d,1/w and in special circumstances)or none.Urine specimen was collected and tested on 1 d,5 d,7 d,10 d,14 d,21 d and before the catheter withdrawal.The incidence rates of catheter-associated urinary tract infection of the groups were observed.Results The infection rate of patients without bladder irrigation(13.33％)was similar to those given bladder irrigation once a week(13.33％),but was lower than those given bladder irrigation twice a day (56.67％)and once a day(36.67％).The difference was statistically significant(x2 =18.73,P ＜ 0.01).The positive rate of urine culture in patients without bladder irrigation(20.00％)was lower than those given bladder irrigation once a week or in special circumstances(30.00％),those given bladder irrigation once a day (53.33％)and twice a day(76.67％).The difference was statistically significant(x2 =23.30,P ＜ 0.01).The frequency of bladder irrigation and duration of catheter indwelling were the risk factors of urinary tract infection.Conclusions Frequent bladder irrigation has no effect on preventing urinary infection.Individual schedule of bladder irrigation should be made according to the patients' condition.