目视管理方法在剖宫产手术隔离技术中的应用  

The application of visual management in surgical isolation of cesarean section

作　　者：宋春[1] 唐乃梅[1] 闫泓霖[1] SONG Chun;TANG Naimei;YAN Honglin(The Second Affiliated Hospital of Xinjiang Medical University, Urumqi 830063, China)

机构地区：[1]新疆医科大学第二附属医院,乌鲁木齐830063

出　　处：《新疆医科大学学报》2019年第5期652-655,662,共5页Journal of Xinjiang Medical University

基　　金：新疆医科大学科研创新基金(XYDCX201627)

摘　　要：目的观察目视管理方法实施剖宫产手术隔离技术的应用效果。方法将实施剖宫产手术的160例患者随机分为对照组和观察组,对照组按常规实施剖宫产手术隔离技术,观察组应用目视管理方法实施剖宫产手术隔离技术,采用剖宫产术中隔离措施实施评价表观察2组手术隔离技术实施情况,比较目视管理方法实施剖宫产手术隔离技术的效果。结果 (1)剖宫产手术隔离防范措施实施情况比较:剖宫产手术12项隔离措施中,第3项破膜弯钳妥善隔离放置,第8项缝合子宫使用的手术器械隔离放置,观察组剖宫产手术隔离防范措施实施执行优于对照组(P<0.05);(2)剖宫产术中发生子宫内膜污染情况比较:第2项擦拭宫腔的纱布未造成污染,第4项缝合子宫时,器械纱布未造成污染,观察组隔离效果优于对照组(P<0.05);(3)剖宫产隔离技术中手术人员隔离情况比较:2组主刀医生与第一助手隔离情况比较差异无统计学意义(P>0.05),第二助手隔离情况差异有统计学意义(P<0.05),器械护士隔离情况差异有统计学意义(P<0.01)。结论目视管理方法有效管理剖宫产手术隔离技术实施,促进手术人员对术中的隔离技术的关注,有利于参与手术人员之间的协同合作,确保隔离技术的执行效果,降低医源性种植的几率。Objective To observe the application effect of visual management method in the isolation technique of caesarean section. Methods 160 patients undergoing cesarean section were randomly divided into control group and observation group. The control group was performed routine cesarean section isolation technique, and the observation group was performed visual management technique. The status of implementation of operation isolation technique in cesarean section was assessed by evaluation table of implementation of isolation measures in cesarean section, and the implementation effect in both groups were compared. Results(1) Comparison of the implementation of precautionary measures for the isolation of caesarean section: Among the 12 isolation measures for caesarean section, the third one was properly placed in isolation with membrane breaking pliers, and the eighth one was placed in isolation with surgical instruments used for uterine suture. The implementation of the third and the fifth preventive measures for cesarean section in the observation group were superior to that in the control group(P<0.05).(2) Comparison of uterine membrane contamination during caesarean section: No contamination was caused by the gauze in the second stage of wiping the uterine cavity, and no contamination was caused by the instrument gauze in the fourth stage of suturing the uterus. The isolation effect of the observation group was better than that of the control group(P<0.05);(3) Comparison of surgical isolation in cesarean section isolation: There was no statistical difference between the isolation of the two groups of lead surgeons and the first assistant(P>0.05), and the comparison of the second assistant isolation in the two groups was statistically significant(P<0.05). The difference in the isolation of instrument nurses between the two groups was statistically significant(P<0.01). Conclusion The visual management method can effectively manage the implementation of the isolation technology for cesarean section, promote the attent

关 键 词：目视管理方法 剖宫产 隔离 医源性种植 

分 类 号：R612[医药卫生—外科学]