肾移植受者留置导尿管时间探讨及护理对策

目的探讨肾移植受者留置导尿管时间与发生尿路感染的关系，并总结预防尿路感染的有效护理措施。方法选取2006年1月～2007年12月在本科室行同种异体肾移植手术的受者83例。所有患者术前留置导尿管，于拔除导尿管前行尿培养。观察患者拔除尿管当天的症状，对尿培养结果进行分析。结果患者尿培养结果阳性23例。其中留置导尿时间10d以上的患者尿培养阳性率明显高于留置导尿时间10d内（含10d）的患者，差异有统计学意义（P〈0．05）。结论建议肾移植受者留置导尿管拔除时间为术后第9～10d，而执行环境消毒措施、预防逆行性感染，保持出入量平衡是预防尿路感染的有效护理措施。

Nursing of preventing catheter-associated urinary infection in patients after kidney transplantation

Objective To approach the appropriate time to extract the ureter and useful nursing to prevent catheter-associated urinary infection in patients who received renal transplantation. Methods Eighty-three patients were picked out with an exclude- standard, who underwent the surgery of allograft renal transplantation from January 2006 to December 2007. All patients were catheterized before the operations and treated with immunosuppressant and preventive use of antibiotics in the operation. Urine culture before the removal of the ureter was analyzed. Results Urine culture results were positive in twenty-three patients. The positive rate of the urine culture in the patients who had kept their ureters for more than 10 days increased obviously, compared with the one of the patients who had kept their ureters for less than 10 days. Significant differences were found （ P 〈 0. 05 ）. Conclusion We suppose to extract the ureter in the 9th or 10th day after the renal transplantation. The removal of predisposing factor is a useful nursing measure to prevent catheter-associated urinary infection.