- 學位論文
探討尿液酸鹼值及攝液量對加護病房導尿管留置病患泌尿道感染之預測成效
Explore monitoring urine PH and fluid intake of ICU patient with Indwelling urinary catheter on predicting the occurrence urinary tract infection
摘要
導尿管留置相關泌尿道感染為常見的院內感染之一，加護病房常因病患病況需要而有導尿管留置，加護病房導尿管留置相關泌尿道感染密度高達5.1‰。本研究旨在探討尿液酸鹼值及攝液量與加護病房導尿管病患泌尿道感染發生之關係。 研究採用縱貫性歷史研究設計，採立意取樣，以高雄某醫學中心加護病房作為研究場所，收案對象為有導尿管留罝無泌尿道感染之病患，共收案61位。收案工具包括：人口學及疾病特性調查表、泌尿道感染症狀調查表、輸入及排出量表及尿液酸鹼試紙及測定儀；施測時機為收案隔天及轉出加護病房前或轉到病房的隔天；使用SPSS 20.0版本軟體進行描述性統計及廣義估計方程式模式(generalized estimating equation)（GEE）之推論統計分析。 卡方及t檢定結果發現前、後測之尿液混濁、前測之尿比重及前、後測之尿液滲透壓不同分別在後測菌尿症的發生有顯著差異；GEE檢定結果發現尿液混濁為菌尿症之預測因子，建議未來能將尿液有無混濁當作菌尿症發生之偵測指標，以期能提早預測菌尿症之發生。
並列摘要
Catheter associated urinary tract infection is one of the most common nosocomial infections. The catheterization is often performed on the patients if they are under poor conditions in intensive care units (ICU). However, the incidence of catheter-associated urinary tract infection (CAUTI) in the intensive care units is up to 5.1 ‰. This study was attempted to explore the value of urine pH and fluid intake on the occurrence of urinary tract infection (UTI) for the patients with catheterization in ICU. The longitudinal historical cohort design was adopted for this study, and the purposive sampling was selected for the patients with indwelling urinary catheter and were hospitalized in ICU at a medical center in Kaohsiung. Sixty-one patients participated in this study. The measurement tools include the questionnaires of demographic and disease characteristics, urinary tract infection symptoms questionnaire, intake and output record sheet, urine pH strip and pH test meter. The tests were started after the patients agree to participant the study until they were discharged from the ICU or transferred to the ward. The data were analyzed using chi-square and t-test for descriptive statistics and generalized estimating equation(GEE) for inferential statistics. The results showed that there were significant differences between the first and second urine specific gravity, urine osmolarity, the second urine appearance with turbid and the second test of bacteriuria. It was find the urine appearance with turbid could be used as a predictor of bacteriuria based on the result of GEE. Thus, the urine appearance with or without turbid is recommended to be the indicator of bacteriuria for the early detection of bacteriuria.
參考文獻
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