摘要
目的分析腹腔镜卵巢癌肿瘤细胞减灭术(OTRO)后发生尿路感染的相关因素,并探讨了相关护理策略。方法回顾性选取2019年10月—2022年10月在南京医科大学附属淮安第一医院接受腹腔镜OTRO治疗的卵巢癌患者228例作为研究对象。根据患者术后是否发生尿路感染将患者分为感染组和未感染组,收集2组患者临床相关资料,比较2组间差异;利用多因素Logistic回归分析影响患者发生尿路感染的独立危险因素。结果228例患者术后尿路感染61例,感染率为26.75%,其中以尿路刺激征、发热为主要临床表现。感染组患者年龄大于非感染组,术中出血量多于非感染组,导尿管留置时间、住院时间均长于非感染组(P<0.05);感染组中有糖尿病、肿瘤分期在ⅢC期~ⅣA期、导尿管插管次数>2次、尿道口清洁次数在1~2次/d、尿袋更换次数≤1次/d、术后发生低蛋白血症的患者占比均高于非感染组(P<0.05);有糖尿病、肿瘤分期高、导尿管留置时间长、术后发生低蛋白血症是影响卵巢癌患者OTRO后出现尿路感染的独立危险因素(P<0.05),尿道口清洁次数日频率高是其保护因素(P<0.05)。结论卵巢癌患者腹腔镜OTRO后发生尿路感染与多种因素有关,有糖尿病、肿瘤分期高、导尿管留置时间长、术后发生低蛋白血症是术后尿路发生感染的独立危险因素,尿道口清洁次数日频率高是其保护因素。临床可针对以上结果制定相关护理措施,以预防尿路感染的发生。
Objective To analyze the factors associated with urinary tract infections(UTIs)after laparoscopic ovarian tumor reduction operation(OTRO)and to explore relevant nursing strategies.Methods A retrospective study was conducted on 228 ovarian cancer patients who underwent laparoscopic OTRO at our hospital from October 2019 to October 2022.Patients were allocated to an infection group and a non-infection group based on the presence of postoperative UTIs.Clinical data were collected and compared between the two groups.Multivariate logistic regression analysis was used to identify independ-ent risk factors for UTIs.Results Postoperative UTIs occurred in 61 of 228 patients,with an infection rate of 26.75%,mainly presenting with urinary irritation and fever.The infection group had significantly older patients,more intraoperative blood loss,longer catheterization,and longer hospital stays compared to the non-infection group(P<0.05).Factors such as diabetes,advanced tumor stage(ⅢC-ⅣA),more than two catheter insertions,cleaning the urethral orifice 1-2 times/day,changing urine bags≤1 time/day,and postoperative hypoproteinemia were significantly more prevalent in the infection group(P<0.05).Independent risk factors for UTIs included diabetes,advanced tumor stage,prolonged catheterization,and postoperative hypoproteinemia(P<0.05),while higher frequency of urethral orifice cleaning was a protective factor(P<0.05).Conclusion The occurrence of UTIs after laparoscopic OTRO in ovarian cancer patients is associated with mul-tiple factors.Diabetes,advanced tumor stage,prolonged catheterization,and postoperative hypoproteinemia are independent risk factors,while frequent urethral cleaning is a protective factor.Targeted nursing measures based on these findings can help prevent UTIs.
作者
高如
张泽惠
杨阳
王静
徐燕
Gao Ru;Zhang Zehui;Yang Yang;Wang Jing;Xu Yan(Gynecology Department,The First Affiliated Huai'an No.1 Hospital of Nanjing Medical University,Huai'an Jiangsu223300,China)
出处
《保健医学研究与实践》
2024年第3期106-111,共6页
Health Medicine Research and Practice
基金
江苏省卫生健康委科研项目(M2020100)。
关键词
腹腔镜
卵巢癌
卵巢癌肿瘤细胞减灭术
尿路感染
预防策略
Laparoscope
Ovarian cancer
Ovarian tumor reduction operation
Urinary tract infection
Preventive strategies
