重症患者导管相关性尿路感染的影响因素及差异性分析

杨青兰; 曾登芬; 刘蕾; 何海燕; 杨文群; 刘丁; 王豪

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重症患者导管相关性尿路感染的影响因素及差异性分析

临床医学 | 更新时间：2026-01-09

- 重症患者导管相关性尿路感染的影响因素及差异性分析
- Influencing factors and differences in catheter-associated urinary tract infections in critical patients
- 陆军军医大学学报 2016年38卷第9期页码：1003-1009
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  中图分类号： R181.32;R472.92;R695.01
- 纸质出版：2016
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杨青兰,曾登芬,刘蕾,何海燕,杨文群,刘丁,王豪.重症患者导管相关性尿路感染的影响因素及差异性分析[J].陆军军医大学学报(原第三军医大学学报),2016,38(09):1003-1009.

　Yang Qinglan,Zeng Dengfen,Liu Lei,He Haiyan,Yang Wenqun,Liu Ding,Wang Hao.Influencing factors and differences in catheter-associated urinary tract infections in critical patients[J].J Amry Med Univ (J Third Mil Med Univ),2016,38(09):1003-1009.
杨青兰,曾登芬,刘蕾,何海燕,杨文群,刘丁,王豪.重症患者导管相关性尿路感染的影响因素及差异性分析[J].陆军军医大学学报(原第三军医大学学报),2016,38(09):1003-1009. DOI：

　Yang Qinglan,Zeng Dengfen,Liu Lei,He Haiyan,Yang Wenqun,Liu Ding,Wang Hao.Influencing factors and differences in catheter-associated urinary tract infections in critical patients[J].J Amry Med Univ (J Third Mil Med Univ),2016,38(09):1003-1009. DOI：

摘要

目的探讨重症患者导管相关性尿路感染(catheter-associated urinary tract infections

CAUTI)的影响因素及差异性。方法采用自行设计的经过信度和效度检验的留置尿管评估观察表，前瞻性监测某院13个病区留置尿管的重症住院患者654例，包括本科室置管和带管入院2组患者CAUTI的影响因素并分析其差异性。结果本科室置管的重症患者417例，发生CAUTI 56例，CAUTI影响因素的多因素分析结果显示：女性，OR=5.937，95%CI(1.474~23.909)；ICU置管，OR=60.499，95%CI(1.455~2515.992)；置管前未预先连接尿管与集尿袋，OR=5.585，95%CI(1.278~24.411)；置管时手触摸尿管前端，OR=9.802，95%CI(2.413~39.816)；尿管留置时间≥7 d，OR=47.652，95%CI(9.733~233.297)；尿管留置时间≥14 d，OR=334.843，95%CI(56.700~1977.434)；乳胶尿管，OR=0.158，95%CI(0.037~0.671)。带管入院237例，发生CAUTI 38例，Logistic回归分析结果显示：尿管留置时间≥7 d，OR=7.277，95%CI(2.004~26.420)；尿管留置时间≥14 d，OR=57.492，95%CI(16.549~199.728)；置管后未更换引流袋，OR=3.429，95%CI(1.245~9.443)；乳胶尿管，OR=0.323，95%CI(0.123~0.846)。2组重症患者CAUTI影响因素差异性分析结果显示：心血管疾病、慢性呼吸道疾病、三腔尿管、更换引流袋及普通引流袋对本科室置管组重症患者CAUTI的影响稍大于带管入院组，而尿管留置时间及乳胶尿管对本科室置管组重症患者CAUTI的影响稍小于带管入院组，2组差异有统计学意义(P0.05)。结论女性、ICU置管、置管前未预先连接尿管与集尿袋、置管时手触摸尿管前端及尿管留置时间是本科室置管重症患者CAUTI的危险因素，乳胶尿管则是保护因素；尿管留置时间和置管后未更换引流袋是带管入院重症患者CAUTI的危险因素，乳胶尿管也是保护因素。针对相关因素进行预防性干预和规范护理，对降低CAUTI发生率具有重要意义。

Abstract

Objective To investigate the influencing factors and differences in catheter-associated urinary tract infections (CAUTI) in critical patients. Methods A prospective investigation was carried out on critical inpatients with indwelling urinary catheter from 13 departments of a Grade A Class Ⅲ hospital during August 2014 and April 2015. Our self-made survey form which had been verified for its reliability and validity was used to explore the influencing factors and analyze the differences between those with catheter inserted in their own departments and those with catheterization before admission or in other departments. Results Among the 417 patients with urinary catheter inserting in their own departments

there were 56 patients suffering from CAUTI. Multivariate analysis showed that the influencing factors were female (OR=5.937

95%CI: 1.474～23.909)

inserting catheter in ICU (OR=60.499

95%CI: 1.455～2515.992)

not connected the ureter with urine tubes and collection bags in advance (OR=5.585

95%CI: 1.278～24.411)

touching the distal part of catheter (OR=9.802

95%CI: 2.413～39.816)

indwelling time of catheter ≥7 d (OR=47.652

95%CI: 9.733～233.297)

indwelling time of catheter ≥14 d (OR=334.843

95%CI: 56.700～1977.434)

and rubber urinary catheter (OR=0.158

95%CI: 0.037～0.671). For the 237 patients with catheter before admission

there were 38 suffering from CAUTI

and the influencing factors were indwelling time of catheter ≥7d (OR=7.277

95%CI: 2.004～26.420)

indwelling time of catheter ≥14 d (OR=57.492

95%CI: 16.549～199.728)

not replacing the drainage bag (OR=3.429

95%CI: 1.245～9.443)

and rubber urinary catheter (OR=0.323

95%CI: 0.123～0.846). The analysis on the influencing factors for CAUTI between the 2 groups showed that cardiovascular disease

chronic respiratory diseases

triple lumen catheter

replacing the drainage bag and conventional drainage bag influenced greater on the group of inserting catheter in their own department than the group with catheter at admission

but indwelling time and rubber urinary catheter had slight effects (P0.05). Conclusion Female

inserting catheter in ICU

not connecting to the ureter with urine tube and collection bags in advance

touching the distal part of catheter and indwelling time of catheter are risk factors for the patients with catheterization in their own departments

but rubber urinary catheter is a protective factor. However

indwelling time of catheter and not replacing the drainage bag are risk factors for those with catheter at admission

but rubber urinary catheter is a protective factor too. Therefore

it is of great significance to prevent these risk factors and take targeted intervention to reduce the incidence of infection.

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