呼吸加護病房提早拔除導尿管措施效果之評估

The Evaluation of Early Removal of Foley Catheter in a Respiratory Intensive Care Unit

陳淑媛(Shu-Yuan Chen)

《The Changhua Journal of Medicine》 6卷4期 (2001/10) Pp. 246-250

摘要

目的：本研究目的在評估實施提早拔除導尿管措施對院內泌尿道感染發生率之影響。
方法：以民國87年間呼吸加護病房之所有住院患者為研究對象，並以l至7月的住院患者為對照組，共109人；8至12月的住院患者為實驗組，共95人。實驗組介入措施為插入導尿管滿7天時，予以拔除導尿管，且不再插導尿管，對照組則每7天更換導尿管。進而評估此兩組的泌尿道感染發生率及拔除導尿管後之自解率。
結果：實驗組泌尿道感染發生率為11.58%，對照組為22.94%，實驗組較對照組發生率低，但此一差異未達統計上顯著水準(x2=3.76; p=0.053)。
結論：提早拔除導尿管措施後的自解率達85.71%，且泌尿道感染發生率低於持續更換導尿管之對照組。導尿管留置時，每天約有5%的感染機會，縮短導尿管留置天數，應可有效降低泌尿道感染率，唯其最佳拔管天數，需待進一步研究。

關鍵字

呼吸加護病房 ； 泌尿道感染 ； 導尿管

並列摘要

Objective: The purpose of this study was to evaluate the effect of early removal of Foley catheters on the occurrence of urinary tract infections (UTI) in patients at a respiratory intensive care unit (RICU) of a medical center.
Methods: All patients admitted to the RICU during 1998 were studied and divided into two groups: (1) a study group of 95 patients admitted from August to December, and (2) a control group of 109 patients admitted from January to July. The cut-off time for either removing or replacing a Foley catheter was 7 days after its placement. In the study group, Foley catheters were removed on the 7th day; in the control group, Foley catheters were replaced with a new set.
Results: The occurrence of UTI rate was 11.58% in study group and 22.94% in control group (2=3.76, p=0.053).The results demonstrated no statistical difference of UTI occurrence between the study and control groups.
Conclusion: Approximately 86% of patients in the study group were able to successfully self urinate after removal of the Foley catheter. To ensure this study has a greater accuracy the sample size in the study group should be greater. Following this study, it is suggested that a Foley catheter can be removed less than the 7th day after its placement in order to successfully reduce the occurrence of UTI.

並列關鍵字

respiratory intensive care unit (RICU) ； urinary tract infection (UTI) ； Foley catheter evaluation study