Clinical study on reducing urinary tract infection in ICU patients with ketoacidosis by using modified Sanhuang Decoction perineal rinse nursing
运用加味三黄汤会阴冲洗护理降低ICU酮症酸中毒患者尿路感染临床研究

摘要

目的 在ICU酮症酸中毒患者护理中运用加味三黄汤会阴冲洗，观察该护理方式在降低患者尿路感染发生率中的效果。方法 选取遂宁市中医院重症医学科糖尿病酮症酸中毒患者50例为研究对象，收治时间2021年6月-2022年4月，采用随机原则分组，每组各25例，两组均给予常规护理，对照组采用稀释碘伏进行尿道冲洗，观察组采用加味三黄汤剂进行尿道口冲洗，疗程为5-7d，每日2次。比较两组酸中毒纠正时间、血糖控制时间及ICU住院时间；比较两组血常规、尿常规及尿路感染发生情况。结果 观察组酸中毒纠正时间、血糖控制时间以及ICU住院时间均短于对照组（P<0.05）。观察组hs-CRP、白细胞计数及尿液WBC各项指标均优于对照组（P<0.05）。观察组尿路感染发生率6.00%（3/50），对照组发生率26.00%（13/50），两组间差异有显著性（P<0.05）。结论 在ICU酮症酸中毒患者护理中运用加味三黄汤会阴冲洗，可显著改善患者的尿道生理环境，降低尿路感染发生率，对促进其血糖控制及病情改善也有积极价值，值得临床应用推广。

Abstract

Objective To observe the effect of modified Sanhuang Decoction perineal flushing in ICU patients with ketoacidosis in reducing the incidence of urinary tract infection.
Methods Selection of suining city hospital intensive medicine 50 patients with diabetic ketoacidosis as the research object, and treating time on June 6, 2021-April 2022, adopt the principle of random grouping, each group of 25 patients, two groups were given conventional nursing, the control group using dilute iodine volts to urethral flushing, observation group with three yellow medicinal broth flavored urethral mouth rinse, The course of treatment was 5-7 days, twice a day. The acidosis correction time, blood glucose control time and ICU stay time were compared between the two groups. Blood routine, urine routine and urinary tract infection were compared between the two groups.
Results The time of acidosis correction, blood glucose control and ICU stay in the observation group were shorter than those in the control group (P<0.05). Hs-crp, white blood cell count and urine WBC in the observation group were better than those in the control group (P<0.05). The incidence of urinary tract infection was 6.00% (3/50) in the observation group and 26.00% (13/50) in the control group, and there was significant difference between the two groups (P<0.05).
Conclusion   Perineal irrigation with modified Sanhuang Decoction in ICU patients with ketoacidosis can significantly improve the urethral physiological environment of patients, reduce the incidence of urinary tract infection, and has positive value in promoting blood glucose control and improving the condition of patients, which is worthy of clinical application and promotion.