不同标记方法对手术部位皮肤消毒效果的影响  

Effects of different marking methods on the skin disinfection at the surgical site

作　　者：谢锷[1] 王小忠[1] 柯永坚[2] 黄旭华[3] 张晓鹏[1] Xie E;Wang Xiaozhong;Ke Yongjian;Huang Xuhua;Zhang Xiaopeng(First Department of Surgery,Shantou Central Hospital,Affiliated Shantou Hospital of Sun Yat-Sen University,Shantou 515031,China;Department of Laboratory,Pathogenic Microorganisms Culture and Testing Center,Shantou Central Hospital,Affiliated Shantou Hospital of Sun Yat-Sen University,Shantou 515031,China;Central Operating Room,Shantou Central Hospital,Affiliated Shantou Hospital of Sun Yat-Sen University,Shantou 515031,China)

机构地区：[1]汕头市中心医院,中山大学汕头附属医院普外一科,515031 [2]汕头市中心医院,中山大学汕头附属医院检验科病原微生物培养检测中心,515031 [3]汕头市中心医院,中山大学汕头附属医院中心手术室,515031

出　　处：《中华现代护理杂志》2020年第18期2475-2478,共4页Chinese Journal of Modern Nursing

基　　金：广东省汕头市重点科技计划项目(汕府科[2015]132-125号)。

摘　　要：目的比较不同标记方法下手术部位皮肤消毒的效果。方法2015年6月—2018年8月选择健康志愿者200名在某医院手术室采集样本。采用自身配对设计,在每名志愿者上腹部设立空白对照A区,另用灭菌记号笔按B、C、D、E区进行标记,其中B、C区直接在腹部皮肤标记划线(B区划实线,C区划虚线),D、E区先消毒皮肤后作标记划线(D区划实线,E区划虚线)。消毒后分别在A、B、C、D、E区采集标本进行细菌培养,检测消毒效果。结果200名健康志愿者共采集到1000份样本,其中细菌培养阳性39份,阳性样本检出的菌落数为1~6 cfu/cm2;划实线标记区的皮肤细菌培养阳性率高于划虚线区,不同分区的标本细菌培养阳性率比较差异有统计学意义(Q=51.87,P<0.01)。进一步两两比较显示,先划线后消毒的B、C区与A区比较,差异均有统计学意义(χ2值分别为20.05、9.09;P<0.05);而先消毒后划线的D、E区与A区比较差异均无统计学意义(P>0.05);B区的细菌检出率高于C区,差异有统计学意义(χ^2=7.97,P<0.05);D区的细菌检出率高于E区,但差异无统计学意义(P>0.05)。结论对手术部位皮肤进行标记、消毒会对皮肤消毒效果产生影响,建议手术部位皮肤先消毒、后标记,并采用虚线进行标记的方法。Objective To compare the skin disinfection effect in different marking methods.Methods From June 2015 to August 2018,samples of 200 healthy volunteers were collected in the operating room of a hospital.Using self-matching design,a blank control area A was set up in the upper abdomen of every volunteer,and sterile markers were used to mark areas B,C,D and E.Areas B and C were directly marked on the abdominal skin(solid line of area B,dashed line of area C),and areas D and E were marked after the skin was disinfected first(solid line of area D,dashed line of area E).After disinfection,specimens were collected in areas A,B,C,D,and E for bacterial culture and the disinfection effect was monitored.Results A total of 1000 samples were collected from 200 healthy volunteers.Among them,39 bacterial cultures were positive and the number of colonies detected in the positive samples was 1 to 6 cfu/cm^2.The positive rate of skin bacterial culture in the marked area of solid line was higher than that in marked area of dashed line.The differences in the positive rates of bacterial culture in different areas were statistically significant(Q=51.87,P<0.01).Further pairwise comparison showed that the differences between the areas B and C that were first drawn lines and then disinfected and area A were statistically significant(χ2=20.05,9.09,P<0.05).However,there was no statistically significant difference between areas D and E that were first disinfected and then drawn lines and area A(P>0.05).The detection rate of bacteria in area B was higher than that in area C,and the difference was statistically significant(χ2=7.97,P<0.05).The detection rate of bacteria in area D was higher than that in area E,but the difference was not statistically significant(P>0.05).Conclusions Marking and disinfecting the skin at the surgical site will have an effect on the skin disinfection effect.It is recommended that the skin at the surgical site be disinfected first and then marked,and the method of dashed line marking should be adopted.

关 键 词：消毒 手术部位 皮肤标记 细菌培养 

分 类 号：R613[医药卫生—外科学]