手术室无菌灯柄不同时段细菌污染调查  

Investigation on bacterial contamination of sterile lamp handle in different periods in operating rooms

作　　者：孙静[1] 李育红[1] 单单单 王亚丰[1] 李温霞[1] 孙明杰[1] 

机构地区：[1]河南省人民医院手术部,河南郑州450003

出　　处：《中华医院感染学杂志》2017年第11期2628-2631,共4页Chinese Journal of Nosocomiology

摘　　要：目的探讨无菌手术时手术室无菌灯柄不同时段细菌污染状况,为医院感染的预防提供参考。方法选取2015年6月-8月医院层流手术室内无影灯无菌灯柄100个(100台手术),在灯柄使用0、1、2、3、4、5、6h时对灯柄采样,并进行细菌培养。结果 100个灯柄其中23个细菌培养阳性,阳性率23.00%,术中有23个有血迹或患者体液污染;不同手术室级别、手术切口类型下灯柄细菌污染阳性率比较差异无统计学意义,手术室内人数>10人、有血迹或体液污染时灯柄细菌污染阳性率为37.50%、39.13%,高于手术室内人数≤10人、无血迹或体液污染时灯柄细菌污染阳性率,比较差异有统计学意义(P<0.05);在灯柄使用2h之前无细菌污染,使用3、4、5、6h时细菌培养阳性率分别为1.00%、4.00%、7.00%、11.00%,分别占4.35%、17.39%、30.43%、47.83%;23个细菌培养阳性的无菌灯柄共培养出31株病原菌,其中凝固酶阴性葡萄球菌、微球菌属、金黄色葡萄球菌、大肠埃希菌、真菌,分别占29.04%、22.58%、16.13%、12.90%、6.45%。结论无菌手术时手术室无菌灯柄随着使用时间延长细菌污染率增加,手术室人员数量及灯柄被患者血迹或体液污染可导致灯柄细菌污染率增加,应针对以上因素进行干预以减少灯柄污染率,从而降低医院感染风险。OBJECTIVE To discuss bacterial contamination of sterile lamp handle in different periods during aseptic surgery in operating rooms,so as to provide references for the prevention of nosocomial infections.METHODS A total of 100 sterile shadowless lamp handles of laminar flow operating room form Jun.2015 to Aug.2015 were selected （100 operations）.The lamp handles were sampled at0,1,2,3,4,5,and6 h during using,and thebacteria were cultured.RESULTS Totally 23 lamp handles were positive in bacterial culture,with the positive rate of 23.00%.Totally 23 lamp handles were contaminated by blood or body fluids.The positive rates of lamp handles of different levels of operating rooms and different types of incision had no significant difference.The positive rates of lamp handles were 37.50% and 39.13% when the number of personnel in operation room〉 10,and with blood or body fluid contamination,which were significantly higher than those when the number of personnel in operation room ≤10 and without blood or body fluid contamination （P〈0.05）.There was no bacterial contamination of lamp handles in the first 2 h,and the positive rates of bacterial culture were 1.00%,4.00%,7.00%,and 11.00% at 3,4,5,and 6 h,accounting for 4.35%,17.39%,30.43%,and 47.83%,respectively.Totally 31 strains of bacteria were cultured,coagulase-negative Stophylococcus,Micrococcus,Staphylococcus aureus,Escherichia coli,and fungi,accounting for 29.04%,22.58%,16.13%,12.90%,and 6.45%,respectively.CONCLUSION During aseptic surgery,the rate of bacterial contamination of sterile lamp handles in operation room increases with the extension of using time,and the number of personnel in operation room and the lamp handles were contaminated by blood or body fluid can lead to increased bacterial contamination rate,so interventions should be carried out.In view of the above factors to reduce the incidence of lamp handle contamination,we can reduce the incidence of nosocomial infection.

关 键 词：无菌手术 层流手术室 灯柄 细菌 污染 时间 

分 类 号：R612[医药卫生—外科学]