层流手术室术中手术器械细菌学动态监测  

Bacteriological dynamic monitoring of surgical instruments in laminar flow operating rooms

作　　者：周学颖[1] 赵峰[1] 王萃[2] 李晓静[1] 周乐[3] 

机构地区：[1]吉林大学中日联谊医院手术室,吉林长春130033 [2]吉林大学中日联谊医院信息中心,吉林长春130033 [3]吉林大学中日联谊医院甲状腺外科,吉林长春130033

出　　处：《中华医院感染学杂志》2015年第9期2142-2144,共3页Chinese Journal of Nosocomiology

基　　金：吉林省科技厅基金资助项目(20130206062SF)

摘　　要：目的研究层流手术室术中手术器械在不同时间段的细菌污染状况,探讨手术器械污染与器械是否暴露在空气中的关联性,为降低术中手术器械不安全因素、预防和控制手术部位感染的发生提供依据。方法选取医院2013年3-11月进行神经外科手术患者120例,随机分为A、B、C 3组,每组各40例,A组手术器械使用后直接放置在无菌台,完全暴露在空气中;B组手术器械使用后放置在无菌台并加以棉织布治疗巾覆盖;C组手术器械使用后放置在无菌台并加以无纺布治疗巾覆盖,分别于手术开始前、术中4、5、6、7h5个时段对每台手术使用的手术器械取3个样本进行细菌培养,将结果进行比较。结果 A、B、C 3组手术器械被检测器械均为600件,合格率分别为91.00%、96.50%、99.33%,3组合格率比较差异有统计学意义(P<0.05);在各时段比较中,在手术开始至术中4h内3组手术器械均未检测出有细菌生长,3组器械合格率均为100.00%,3组间差异无统计学意义;术中5h时A、B、C 3组器械合格率分别为95.00%、100.00%、100.00%,3组合格率比较差异有统计学意义(P<0.05);术中6h时A、B、C 3组器械合格率分别为81.67%、92.50%、99.17%,3组合格率比较差异有统计学意义(P<0.05),B、C两组间合格率比较差异有统计学意义(P<0.05);术中7h时A、B、C 3组器械合格率分别为78.33%、90.00%、97.50%,3组合格率比较差异有统计学意义(P<0.05),B、C两组间合格率比较差异也有统计学意义(P<0.05)。结论监测结果表明,手术中无菌器械的污染与器械是否直接暴露在空气中有关,且呈正相关,器械表面的血迹也增加其污染率,因此术中对使用过的器械加以治疗巾覆盖可降低其污染率,同时器械护士也应注意及时擦净器械表面的血迹。OBJECTIVE To study the bacterial pollution of surgical instruments in laminar flow operating rooms in different time periods and explore the correlation between the contaminated surgical instruments and their exposure to air so as to provide evidence to reduce insecurity of intraoperative surgical instruments and prevent surgical site infections .METHODS A total of 120 patients who underwent surgeries in neurosurgery department from Mar 2013 to Nov 2013 were enrolled in the study and randomly divided into the group A ,B ,and C ,with 40 cases in each group;the surgical instruments of the group A were directly placed on the sterile table and fully exposed to the air after they were used ,the surgical instruments of the group B were placed on the sterile table and covered with cot‐ton cloth towel after they were used ,and the surgical instruments of the group C were placed on the sterile table and covered with non‐woven towel after they were used;three samples were collected from the surgical instru‐ments that were used before the surgery ,or at 4 ,5 ,6 ,or 7 hours during the surgery so as to perform bacterial culture ,and the results were observed and compared .RESULTS Totally 600 surgical instruments were tested in each of the three groups ,and the qualified rate was 91 .00% in the group A ,96 .50% in the group B ,99 .33% in the group C ,there was significant difference in the qualified rate among the three groups （P〈0 .05） .The bacterial＆amp;nbsp;growth was not found from the start of surgery to the surgery within 4 hours ,the qualified rates of the instru‐ments of all the three groups were 100 .00% ,there was no significant difference .At 5 hours during the surgery , the qualified rate of the surgical instruments was 95 .00% in the group A ,100 .00% in the group B ,100 .00% in the group C ,there was significant difference in the qualified rate among the three groups （P〈0 .05） .At 6 hours during the surgery ,the qualified rate of the surgical instruments was 81 .67% in the group A ,92 .50% i

关 键 词：手术器械 细菌学监测 棉织布 无纺布 

分 类 号：R197.323[医药卫生—卫生事业管理]