净化手术间环境下移动无影灯产生的菌落数量状况分析  

Analysis on the Number of Colonies Produced by Moving Shadowless Lamp in the Environment of Purifying Operation Room

作　　者：苏锦治 吴华隆 邱巧云 卢海景 郑幼美 杜阿兰 洪芬芬 苏丽寒 张乘璇 SU Jinzhi;WU Hualong;QIU Qiaoyun;LU Haijing;ZHENG Youmei;DU Alan;HONG Fenfen;SU Lihan;ZHANG Chengxuan(Department of Operating Room,Orthopedic Hospital,Quanzhou City,Fujian Province,Quanzhou 362000,China)

机构地区：[1]福建省泉州市正骨医院手术室,福建泉州362000

出　　处：《中国医药指南》2023年第14期61-63,共3页Guide of China Medicine

基　　金：福建中医药大学临床专项科技类课题(XB2020138)。

摘　　要：目的 调查医院手术室内移动无影灯所产生的细菌状况,为医院感染的预防以及专科护士在术中的护理配合提供参考。方法将福建省泉州市正骨医院百级手术间分成试验组与对照组,试验组对无影灯进行移动,操作者严格按《手术室更衣更鞋制度》着装,头戴全包围帽子以及外科口罩,准备完毕后,进入试验术间依序摆放好将空白对照皿、0.5 h、1.0 h和2.0 h的培养皿,双人移动无影灯3次,第1次顺时针360°,第2次逆时针360°,第3次顺时针180°后离开术间。对照组未对无影灯进行移动,试验人员准备完毕后,进入对照术间依序摆放好将空白对照皿、0.5 h、1.0 h和2.0 h的培养皿,不做任何操作,离开术间。在0.5 h、1.0 h、2.0 h后回收2个术间的0.5 h、1.0 h、2.0 h的培养皿,检测移动过程中有无菌落掉落,按照洁净手术室空气培养法统计落菌阳性率。结果 试验组为移动无影灯3次,其阳性率为20.00%,对照组的阳性率为3.33%。在增加了移动无影灯这一变量,试验组的落菌阳性率较对照组高出16.67%,χ^(2)=1.46,P=0.044。结论 移动无影灯会增加细菌掉落的概率,从而增加手术野的细菌量,可在术前提前移动无影灯,使灯光聚焦手术野,尽量减少术中无影灯移动的次数。Objective To investigate the bacterial status of shadowless lamp in the operating room of the hospital,and to provide reference for the prevention of nosocomial infection and the nursing cooperation of nurses during the operation.Methods The operation room of Quanzhou Bone-setting Hospital in Fujian Province was divided into experimental group and control group.The experimental group moved shadowless lamps,and the operator wore a cap and surgical mask in strict accordance with the"dressing and shoe-changing system in the operating room".After preparation,they entered the experimental room and placed blank control dishes,0.5 h,1.0 h and 2.0 h petri dishes in order.The two persons moved the shadowless lamp three times,the first time clockwise 360°,the second time counterclockwise 360°,the third time clockwise 180°after leaving the operation room.The control group did not move the shadowless lamp.After the experimenters were ready,they entered the control room and placed the blank control dish,0.5 h,1.0 h and 2.0 h petri dishes in order,and left the room without any operation.Culture dishes at 0.5 h,1.0 h,and 2.0 h between the two operations were collected after 0.5 h,1.0 h,and 2.0 h to detect whether colonies fell off during the movement,and the positive rate of colonies was counted according to air culture method in clean operating room.Results The positive rate of shadowless lamp was 20.00%in the experimental group and 3.33%in the control group.When the variable of moving shadowless lamp was added,the positive rate of shadowless lamp in the experimental group was 16.67%higher than that in the control group,the difference was statistically significant,χ^(2)=1.46,P=0.044.Conclusion Moving shadowless lamp can increase the probability of falling bacteria,and thus increase the amount of bacteria in the operating field,can move the shadowless lamp in advance before surgery to focus the light on the operating field and reduce the number of movements of the shadowless lamp during the operation.

关 键 词：手术室 无影灯 菌落 医院感染 

分 类 号：R612[医药卫生—外科学]