手术室手术缝合针刺伤现况调查及新型钝性缝合针应用效果分析  

Investigation and intervention of suture needle-stick injuries in operating room

作　　者：王春灵 史庆丰 王成浩 沈敏伟 潘渊 汪怡 WANG Chun-ling;SHI Qing-feng;WANG Cheng-hao;SHEN Min-wei;PAN Yuan;WANG Yi(Nursing Department,Zhongshan Hospital,Fudan University,Shanghai 200032,China;Department of Infection Management,Zhongshan Hospital,Fudan University,Shanghai 200032,China)

机构地区：[1]复旦大学附属中山医院护理部,上海200032 [2]复旦大学附属中山医院感染管理科,上海200032

出　　处：《中国临床医学》2019年第2期268-271,共4页Chinese Journal of Clinical Medicine

基　　金：复旦大学附属中山医院管理基金(2018ZSGL05)~~

摘　　要：目的:对手术室手术缝合针刺伤现状进行调查,探讨降低针刺伤风险的方法。方法:对复旦大学附属中山医院5个科室共计110名外科医师的缝合针刺伤发生现状、原因和处置情况进行问卷调查,并选取20名外科医师作为钝性缝合针(1种防刺伤针)使用小组。20名外科医师2018年1月至6月使用普通缝针(干预前),7月至12月使用钝性缝合针(干预后)。评估使用钝性缝合针后,针刺伤发生的情况。结果:110名外科医师中,19.1%的在最近1个月内发生过缝合针刺伤,主要发生时机为主刀或一助进行手术操作配合对接和术中护士递针给主刀或一助时,且手术时间较长,体力、精神疲惫时发生率最高;52.4%的缝合针刺伤可被外科医师及时发觉,57.1%的外科医师会主动上报。干预前针刺伤发生频率为每天28次/1 000人,干预后针刺伤发生频率为每天7次/1 000人,针刺伤发生率降低75%(IRR=4.061,95%CI 2.357～6.996)。结论:外科医师手术缝合针刺伤发生频率较高,但及时发现率较低,且发生后主动上报比例不高,存在较大的漏报风险;钝性缝合针可一定程度降低外科医师缝合针刺伤风险,值得临床推广应用。Objective:To investigate the current status of suture needle-stick injuries in the operating room,and to discuss the methods of reducing the risk of needle-stick injuries.Methods:A questionnaire survey was conducted regarding the current status of occurrence,causes,and treatment of suture needle-stick injuries in 110 surgeons from 5 departments of the hospital.Among whom,20 surgeons were selected into the blunt suture needles group.The 20 surgeons used ordinary needles from January 2018 to June 2018(before intervention),and used blunt suture needles from July to December(after intervention).The effect of blunt suture needles on the incidence of needle-stick injuries was evaluated.Results:Among 110 surgeons,19.1%had a suture needle-stick injury in the past month.The main time of occurrence was when the main surgeon or assistant carry out the operation and docking,and when the nurse handed the needle to the main surgeon or assistant o during the operation.The incidence was highest when physical and mental exhaustion occurs and operation time was longer.And 52.4%of needle-stick injuries could be discovered by the surgeon in time,and 57.1%of surgeons reported to the related departments on their own initiative.The frequency of needle-stick injury was 28 times/1000 person days and 7 times/1000 person days before and after intervention,respectively,and the incidence of was reduced by 75%(IRR=4.061,95%CI 2.357-6.996).Conclusions:The incidence of needle-stick injury is high,and the timely discovery rate is low,with low report rate on the surgeons’own initiative.The blunt suture needle can reduce the risk of needle-stick injury in the surgery,which is worthy of clinical application.

关 键 词：手术室 缝合针刺伤 钝性缝合针 干预 

分 类 号：R472.3[医药卫生—护理学]