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目的探讨筑建抗菌膜密闭系统在预防导尿管相关性尿路感染中的应用效果。方法 330例住院留置导尿管患者作为研究对象,按照随机数字表法分为A、B、C组,每组110例。A组采用0.1%的碘伏稀释液消毒尿道口;B组采用长效抗菌材料(洁悠神)喷洒尿道口周围皮肤及黏膜;C组采用洁悠神喷洒导尿管内外面、尿道口周围皮肤及黏膜、导尿管体外段、尿袋与尿管接口及尿袋出口,构建抗菌膜密闭引流系统。分别于用药后的第1、3、7、14天行尿沉渣检测及尿液细菌培养,比较三组患者尿白细胞、尿路感染情况。结果 (1)尿液白细胞计数:第1天三组患者尿液均未见白细胞;第3天,C组患者尿液未见白细胞,B组患者白细胞计数明显低于A组患者(P<0.05);第7天,C组患者仍未见白细胞,B组患者白细胞计数明显低于A组患者(P<0.05);第14天,C组患者白细胞计数低于B组患者,同时B组患者白细胞计数低于A组患者,组间两两比较,差异均具有统计学意义(P<0.05)。(2)尿路感染发生情况:第1天,三组患者均未见感染;第3天,C组无感染,B组1例感染,A组3例感染,A、B两组感染率(2.7%VS 0.9%)比较差异无统计学意义(P>0.05);第7天,C组仍无感染,B组8例感染,A组19例感染,B组感染率7.3%明显低于A组17.3%(P<0.05);第14天,C组感染1例,B组感染13例,A组感染25例,C组感染率0.9%低于B组11.8%,B组感染率11.8%低于A组22.7%,组间两两比较,差异均具有统计学意义(P<0.05)。结论筑建抗菌膜密闭系统能够明显降低留置导尿管相关性尿路感染的发生率,其操作简单,安全性好,值得推广。
Objective To investigate the application of antibacterial membrane closed system in the prevention of catheter-related urinary tract infection. Methods A total of 330 hospitalized patients with catheterization were divided into A, B and C groups according to the random number table method, with 110 cases in each group. In group A, the urethral orifice was disinfected with 0.1% iodophor dilution; in group B, the long-term antibacterial material (JYF) was sprayed on the skin and mucosa around the urethral orifice; in group C, the skin surrounding the urethral orifice And mucosa, urinary catheter external body segment, urine bag and catheter interface and urine bag exit, build antimicrobial membrane closed drainage system. Respectively in the first 1,3,7,14 days after administration of urine sediment testing and urine bacterial culture, urinary leukocytes, urinary tract infection in three groups were compared. Results (1) Urine white blood cell count: No white blood cells were found in the urine of the three groups on the first day. On the third day, white blood cells were not found in the urine of the group C and white blood cells in the group B were significantly lower than those in the group A (P <0.05 ). On day 7, white blood cells were still not seen in group C, and white blood cell counts in group B were significantly lower than those in group A (P <0.05). On day 14, white blood cell counts in group C were lower than those in group B, The white blood cell count was lower than that of patients in group A, and the difference between groups was statistically significant (P <0.05). (2) The incidence of urinary tract infection: On the first day, no infection was observed in the three groups of patients. On the third day, there was no infection in group C, one in group B, three in group A, and two in groups A and B 2.7% VS 0.9%). There was no significant difference between the two groups (P> 0.05). On the 7th day, there was no infection in group C, 8 in group B, 19 in group A and 7.3% in group B, (P <0.05). On the 14th day, group C was infected with one case, group B with infection of 13 cases, group A with infection of 25 cases, group C with infection rate of 0.9% less than group B with 11.8% and group B with infection rate of 11.8% Which was lower than that in group A (22.7%). There was a significant difference between any two groups (P <0.05). Conclusion The antibacterial membrane closed system can reduce the incidence of urethral catheter-related urinary tract infection significantly. Its operation is simple, safe and worthy of promotion.