股骨近端闭合防旋髓内钉固定术中使用无菌手套的细菌污染及穿孔情况研究  

Bacterial contamination and perforation of sterile gloves used in closed proximal femoral nail anti-rotation

作　　者：杜海荣[1] 张玉舰[1] 刘瑶[1] 刘阳[2] DU Hai-rong;ZHANG Yu-jian;LIU Yao;LIU Yang(Department of Orthopedics,First Hospital of Qinhuangdao,Qinhuangdao Hebei 066001,China;Department of Hospital-acquired Infection Control,First Hospital of Qinhuangdao,Qinhuangdao Hebei 066001,China)

机构地区：[1]秦皇岛市第一医院骨科,河北秦皇岛066001 [2]秦皇岛市第一医院院感科,河北秦皇岛066001

出　　处：《局解手术学杂志》2023年第1期83-85,共3页Journal of Regional Anatomy and Operative Surgery

摘　　要：目的 探讨股骨近端闭合防旋髓内钉固定术中使用无菌手套的细菌污染及穿孔情况。方法 选取股骨近端闭合防旋髓内钉固定术中使用的1 148个无菌手套为研究对象,对无菌手套细菌检出和穿孔情况进行统计学分析。结果 1 148个无菌手套中,有91个(7.93%)手套检出细菌,共发现113株细菌,主要为金黄色葡萄球菌39株(34.51%)、大肠埃希菌21株(18.58%)及阴沟肠杆菌17株(15.04%)。术中佩戴单层手套在手术结束时细菌检出率明显高于双层手套(P<0.05),在切皮前经聚维酮碘消毒的手套细菌检出率均明显低于未消毒的手套(P<0.05)。手术主刀及器械护士所用手套穿孔率显著高于主刀助手(P<0.05),单层手套的总穿孔率、术后加压发现穿孔率显著高于双层手套(P<0.05)。结论 股骨近端闭合防旋髓内钉固定术中有可能发生无菌手套穿孔导致细菌污染,细菌主要为金黄色葡萄球菌、大肠埃希菌及阴沟肠杆菌。术前聚维酮碘消毒能降低手套细菌检出率,手术主刀与器械护士的手套更易穿孔,建议术中佩戴双层手套。Objective To explore the bacterial contamination and perforation of sterile gloves used in closed proximal femoral nail anti-rotation.Methods A total of 1 148 sterile gloves used in the closed proximal femoral nail anti-rotation were selected, and the bacterial detection and perforation of sterile gloves were statistically analyzed.Results Among the 1 148 sterile gloves, bacteria were found in 91 gloves(7.93%),and 113 strains of bacteria were detected, mainly as 39 strains(34.51%) of Staphylococcus aureus, 21 strains(18.58%) of Escherichia coli and 17 strains(15.04%) of Enterobacter cloacae. The bacterial detection rate of the single-layer gloves at the end of operation was significantly higher than that of the double-layer gloves(P<0.05). The bacterial detection rate of gloves sterilized with povidone iodine before skin cutting was significantly lower than that of the unsterilized gloves(P<0.05).The perforation rates of gloves used by surgical master surgeons and instrument nurses were significantly higher than that of the master surgeons(P<0.05),and the total perforation rate and perforation rate found by compression after operation of the single-layer gloves were significantly higher than those of the double-layer gloves(P<0.05).Conclusion Bacterial contamination caused by sterile gloves perforation may occur during closed proximal femoral nail anti-rotation, and the main bacteria are Staphylococcus aureus, Escherichia coli and Enterobacter cloacae.Povidone iodine sterilization before operation can decrease the detection rate of glove bacteria, and the gloves used by surgical master surgeons and instrument nurses are more prone to perforation, so the double-layer gloves are recommended to used during operation.

关 键 词：股骨近端闭合防旋髓内钉固定术 无菌手套 聚维酮碘 消毒 细菌污染 穿孔 

分 类 号：R446.5[医药卫生—诊断学]