重症有机磷中毒尿路感染的护理研究

目的 探讨ICU内急性重症有机磷农药中毒患者在抢救治疗时合并尿路感染的病原学特点与护理措施。方法 对ICU内的68例急性重症有机磷农药中毒留置导尿的患者，在治疗48h后，采取中段尿作细菌培养、定量分析及药敏试验，细菌学资料作统计学分析。结果 采取中段尿作细菌培养68例次，22次细菌培养阳性。分离菌株9种、24株细菌。主要以革兰阴性杆菌为主，18株占75％，革兰阳性球菌6株占25％。这些细菌具有多耐药性和较高的耐药率。结论 ICU内急性再症有机磷农药中毒留置导尿的患者易并发尿路感染。应进行病原微生物学监测，加强临床观察和护理措施，减少医源性感染，提高ICU内急性重症有机磷农药中毒的抢救成功率。

Clinical study and nursing of urinary tract infection of patients with severe organophosphate poisoning during rescuing treatment

Objective To study the bacteriological data of pathogens of urinary tract infectionfor patients with severe organophosphate poisoning during rescuing treatment in the intensive care unit(ICU) and to research effective nursing intervention.Methods 68 samples of clean medistream urine were collected from 68 patients with severe organophosphate poisoning after 48 hours of detaining urethral catheterization.Bacterial culture,drug-sensitive test and quantitative analysis were done.The data were analyzed statistically.Results The 24 lines of pathogens were separated from 22 of the 68 samples.The chef pathogens were Gram-negative bacilli,18 lines accounted for 75% while Gram-positive bacilli,6 lines accounted for 25%.These pathogens possess multi-drug resistance and higher antibiotic resistance rate.Conclusion The patients with severe organophosphate poisoning in ICU,especially those with detaining urethral catheterization longer than 48 hours can easily be affected by bacteriological pathogens and suffered urinary tract infection. It is necessary to monitor the species of these pathogens in order to guide the correct use of antibiotics,to prevent urinary tract infection for patients with severe organophosphate poisoning during detaining urethral catheterization in the intensive care unit(ICU) and to raise rescue achievement rate of these patients.It is important to strengthen clinical observation and to take effective nursing intervention.