综合管理对骨科洁净手术间空气含菌量的影响  

Effect of integrated management strategies on bacterial content of air in orthopedic clean operating room

作　　者：张穗[1] 陈丹[1] 黎笔熙[1] 陶军[1] 

机构地区：[1]广州军区武汉总医院麻醉科,湖北武汉430070

出　　处：《护理学杂志》2012年第22期13-16,共4页

摘　　要：目的通过监测手术间的空气菌落数,分析干预策略对骨科洁净手术室洁净度的影响。方法选择Ⅰ、Ⅱ和Ⅲ级骨科的洁净手术间,将其每天的第一台手术随机纳入相应级别的干预组和常规组。干预组采用严格控制手术间开门次数、尽量避免人员进出手术间、改善患者入室前的卫生状况等干预策略,常规组按照平常的工作模式完成手术。用撞击法监测患者入手术室前(T1)、手术切皮前(T2)、手术开始30min(T3)和缝合皮肤前(T4)4个时点手术间中央区的浮游细菌浓度,同时用沉降法监测T1、T2、T3时室内周边区的细菌浓度。结果各级手术间干预组开门次数显著低于常规组(均P<0.01);患者进入手术间后,室内空气中的悬浮细菌随着时间的延长明显增多(P<0.05);组间比较,干预主效应差异有统计学意义(均P<0.05)。结论采用综合干预可以有效降低骨科手术间的浮游细菌浓度。Objective To study effect of integrated management strategies on bacterial content of air in orthopedic clean operating room. Methods Class I ,II , and III clean rooms were selected and scheduled for orthopedic surgeries. The first surgery of the day within 6 months conducted in these selected clean rooms was taken as the control group and the intervention group. For the intervention group, the frequency of door opening was controlled, room entry and exit was limited, and patient hygiene before entering the clean rooms was improved, etc. The rooms arranged to conduct the control group surgeries were managed with ordinary mode. Air samples in central zone of the operating rooms were collected by collision method at the time before the entrance of the patient （T1）, before the start of operation （T2）, 30 minutes after the start of operation （T3） and before suturing （T4）. Air samples in periphery of the clean rooms were detected by falling bacteria method at T1 ,T2 and T3. Results The frequencies of door opening in the intervention group surgeries conducted in varied classes of clean rooms were significantly less than those in the control group （P〈0.01 for all）. Bacterial contents suspended in the air in the clean rooms were increased with patient stagnation, with significant differences in group effect between the 2 groups （P〈0.05 for all）. Conclusion The integrated management strategies can effectively decrease the bacterial contents of air in orthopedic clean operating room.

关 键 词：层流手术室 骨科手术 管理策略 细菌含量 

分 类 号：R472.3[医药卫生—护理学] C931[医药卫生—临床医学]