ICU留置导尿管患者泌尿系感染的护理干预效果研究

Study on the Effect of Nursing Intervention on Urinary Tract Infection in Patients with Indwelling Catheter in ICU

摘要: 探讨护理干预对ICU留置导尿管患者泌尿系感染(UTI)发生率及相关预后指标的影响，为临床预防与控制感染提供参考。选取2023年1月至2024年12月入住某三级甲等医院ICU并行留置导尿的患者120例，按随机数字表法分为对照组和干预组，每组各60例。对照组实施常规护理，干预组在此基础上实施包括严格无菌导尿操作、导尿管固定与每日评估、尿道口清洁、液体摄入管理、感染风险宣教等综合干预措施。比较两组泌尿系感染发生率、导尿时间、住院时间及尿液细菌培养阳性率。干预组UTI发生率为6.67% (4/60)，低于对照组的23.33% (14/60) (P < 0.05)；干预组平均导尿时间(5.2 ± 1.1天)和住院时间(12.4 ± 2.5天)均短于对照组(7.8 ± 1.4天、15.1 ± 3.2天) (P < 0.05)；尿液细菌培养阳性率干预组为8.33%，对照组为26.67% (P < 0.05)。针对ICU留置导尿管患者实施系统化护理干预，可显著降低UTI发生率，缩短导尿及住院时间，改善临床结局，具有较高的临床推广价值。

Abstract: To evaluate the effect of nursing interventions on the incidence of urinary tract infection (UTI) and related outcomes in ICU patients with indwelling catheters, and to provide evidence for clinical infection prevention and control. From January 2023 to December 2024, 120 ICU patients with indwelling urinary catheters in a tertiary hospital were randomly divided into a control group (n = 60) and an intervention group (n = 60). The control group received routine care, while the intervention group additionally received a comprehensive nursing intervention, including strict aseptic catheterization procedures, daily catheter fixation and assessment, perineal hygiene, fluid intake management, and infection risk education. The incidence of UTI, catheterization duration, hospital stay, and positive rate of urine bacterial culture were compared between the two groups. The incidence of UTI in the intervention group was 6.67% (4/60), significantly lower than that in the control group (23.33%, 14/60) (P < 0.05). The average catheterization duration (5.2 ± 1.1 days) and hospital stay (12.4 ± 2.5 days) in the intervention group were significantly shorter than those in the control group (7.8 ± 1.4 days, 15.1 ± 3.2 days) (P < 0.05). The positive rate of urine bacterial culture was 8.33% in the intervention group and 26.67% in the control group (P < 0.05). Systematic nursing interventions for ICU patients with indwelling catheters can significantly reduce UTI incidence, shorten catheterization and hospital stay, and improve clinical outcomes, with high clinical application value.