ObjectiveTo explore the influence of evidence-based nursing care of catheterization on the incidence of urinary tract injury and urinary tract infection in patients with spinal cord injury and long-term indwelling catheters.MethodsFrom July 1st, 2017 to November 30th, 2018, 100 patients with spinal cord injury indwelling catheters in Department of Spinal Surgery were prospectively selected as the research objects. According to the admission time, patients admitted between July 2017 and February 2018 were assigned into the control group (n=50), and patients admitted between March 2018 and November 2018 were assigned into the observation group (n=50). Traditional catheter placement was used in the control group, while evidence-based catheter placement was used in the observation group. The incidences of catheter-related urethral injury and urinary tract infection after the catheterization were compared between the two groups.ResultsThere was no statistically significant difference in gender, age, diagnosis, or length of hospital stay between the two groups (P>0.05). Catheter placement was performed 57 times in the control group and 59 times in the observation group during hospitalization. After catheterization, the incidences of urethral hemorrhage and gross hematuria in the control group [22.80% (13/57) and 15.78% (9/57), respectively] were higher than those in the observation group [both were 1.69% (1/59)], with statistical differences between the two groups (P<0.05). The incidence of urinary tract infection in the control group differed from that in the observation group [42.0% (21/50) vs. 18.0% (9/50), P=0.009].ConclusionThe evidence-based urinary catheterization method for patients with spinal cord injury and long-term indwelling catheter can effectively prevent catheter-related urinary tract injury, reduce the incidence of catheter-related urinary tract infection during hospitalization, and improve the quality of clinical care.
Objective To study the catheter-related infection (CRI) in cancer patients treated with central venous catheterization. Methods A prospective study with 196 cancer patients was conducted to analyze the types of catheter-related infection and pathogen, as well as the relationship between CRI and the following factors: insert location, gender, age, remained time, or bone marrow suppression. Results Of the total 196 cases, 16 cases were diagnosed as CRI and the CRI rate was 8.2%. The types of CRI were five cases of pathogen colonization, four cases of insert location infection and seven cases of catheter-related bloodstream infection. Of the total 244 specimens, 20 were positive including 7 pathogenic bacteria in either Gram positive or Gram negative types, the dominating pathogens were staphylococcus aureus, staphylococcus epidermidis, acinetobacter baumannii and klebsiella pneumoniae. CRI was related to both insert location and age which were both the independent risk factors. Conclusion The concept of prevention should be set up, and the comprehensive measures should be taken to reduce CRI, such as choosing an appropriate insert location and complying with a strict catheter insert standard.
ObjectiveTo investigate the clinical efficacy of catheter directed thrombolysis (CDT) through three different approaches combined with iliac venous endovascular therapy for acute deep venous thrombosis (DVT) complicated with Cockett syndrome of the lower extremities. MethodThe clinical data of 87 patients with CDT through three different approaches (small saphenous vein group, popliteal vein group, and posterior tibial vein group) combined with iliac venous endovascular therapy for DVT complicated with Cockett syndrome of the lower extremities were analyzed retrospectively. ResultsThe lower extremity swelling of all the patients were disappeared obviously within 72 h after surgery, there was no death related surgery and pulmonary embolism. The limb edema reduction rates had no significant differences among the small saphenous vein group, popliteal vein group, and posterior tibial vein group﹝(77±13)% versus (82±12)% versus (77±18)%, P > 0.05﹞. The recanalization rates of thrombolysis had no significant differences among the above three groups﹝(86.5±10.6)% versus (92.0±7.7)% versus (87.3±7.8)%, P > 0.05﹞. The time required for the cannulation in the posterior tibial vein group was significantly shorter than that of the small saphenous vein group or popliteal vein group﹝(15.14±3.62) min versus (32.62±9.36) min or (42.79±13.30) min, P < 0.01﹞. All the patients were performed by balloon dilatation and iliac vein stenting. Eighty-seven cases were followed-up for 1-24 months, the primary patency rate of iliac venous was 100%. ConclusionsCDT with iliac venous endovascular therapy is an effective method in treatment of acute DVT with Cockett syndrome. CDT through posterior tibial vein is an easier and effective method with less complications and time. This way could be acceptable in basal hospital.
Objective To summarize some problems about the management of acute pancreatic pseuclocyst (PPC) by CT guided percutaneous drainage (PCD).Methods The recent domestic and foreign literatures were reviewed in order to explore the research advancement, such as indication, applied time, technique skill, complication and curative effect by CT guided PCD. Results This operation could be early performed in patients with acute PPC, preventing and decreasing the incidence of possible complications resulted from the traditional long-term observation and waiting. The technique skill of operation was easy with low incidence of complications and the effect was good. Combined use of somatostatin might shorten the treatment time. Some patients could be postoperatively managed in out-patient, thus the expense could be cut down. Conclusions CT guided PCD is a minimally invasive operation and is easy to perform with high effective rate and low incidence of complications and low cost. Reasonable selection of the indications and improvement of equipments and operation techniques may be helpful to improve the curative effect. The extended application of this operation is advised.