两种消毒剂与手术薄膜对膝关节置换术患者切口感染的影响  

Effects of two kinds of disinfectants and surgical films on incision infections in patients undergoing knee arthroplasty

作　　者：叶金灵[1] 黄芳[1] 马超华[1] 郑岩[1] 姜果[1] 

机构地区：[1]郑州市骨科医院手术室,河南郑州455000

出　　处：《中华医院感染学杂志》2016年第1期139-141,共3页Chinese Journal of Nosocomiology

基　　金：河南省科技厅科技基金资助项目(132102310481)

摘　　要：目的对比3M2%葡萄糖酸氯己定皮肤消毒液联合3M贴膜与聚维酮碘消毒液联合普通手术贴膜在膝关节置换术术前皮肤准备中的临床效果。方法选取2014年7月-2015年2月100例择期行膝关节置换术患者,将其随机分为试验组和对照组,每组各50例;试验组采用3M2%葡萄糖酸氯己定联合使用3M手术贴膜,对照组采用聚维酮碘消毒液联合使用普通手术贴膜贴;对两组患者消毒前、消毒后及手术结束3个时间点皮肤标本的培养菌落数以及术后30d内的伤口并发症发生情况进行对比,评估两组消毒方法的临床效果;采用SPSS17.0软件进行统计分析。结果消毒后10 min试验组细菌较消毒前减少(15.38±2.74)CFU/cm^2,对照组减少(16.18±2.59)CFU/cm^2,两组比较差异无统计学意义;而术后试验组细菌减少(15.34±2.66)CFU/cm^2,对照组减少(14.2±2.84)CFU/cm^2,两组比较差异有统计学意义(P<0.05);试验组无出现伤口感染病例,伤口渗出增多延迟愈合1例,对照组出现1例浅表伤口感染,伤口并发症6例,两组伤口并发症比较差异有统计学意义(P<0.05)。结论膝关节置换术前皮肤消毒以3M皮肤消毒剂及3M2%葡萄糖酸氯己定手术贴膜消毒对皮肤不良反应小、手术伤口感染率低,值得推广应用。OBJECTIVE To observe and compare the clinical effects of the 3M2% gluconate chlorhexidine skin disinfectant combined with 3Moperation film and the povidone-iodine disinfection combined with common operation film on the skin preparation before the knee arthroplasty.METHODS A total of 100 patients who underwent the selective knee arthroplasty from Jul 2014 to Feb 2015 were enrolled in the study and randomly divided into the experimental group and the control group,with 50 cases in each.The experimental group was treated with the 3M20%gluconate chlorhexidine combined with 3Moperation film,while the control group was treated with the povidoneiodine disinfectant combined with common operation film.The bacterial colony counts of the skin specimens cultured before the disinfection,after the disinfection,and at the end of the surgery,as well as the incidence of complications within 30 days after the surgery,were observed and compared between the two groups of patients,and the clinical effects of the two disinfection methods were evaluated;the statistical analysis was performed with the use of SPSS17.0software.RESULTS After the disinfection for 10 min,the bacterial colony counts of the experimental group were decreased by（15.38±2.74）CFU/cm2,the bacterial colony counts of the control group were decreased by（16.18±2.59）CFU/cm2,and there was no significant difference between the two groups.The bacterial colony counts of the experimental group were decreased by（15.34±2.66）CFU/cm2 after the surgery,the bacterial colony counts of the control group were decreased by（14.2±2.84）CFU/cm2,and there was significant difference between the two groups（P〈0.05）.The wound infection did not occur in the experimental group,and 1case had delayed healing of wound;1case had superficial wound infection in the control group,and 6cases had wound complications;there was significant difference in the incidence of wound complications between the two groups（P〈0.05）.CONCLUSION As is used for the skin preparation before th

关 键 词：膝关节置换 消毒剂 手术薄膜 

分 类 号：R619.3[医药卫生—外科学]