关节成形术中细菌污染观察  

Intraoperative Bacterial Contamination in Operations for Joint Replacement

作　　者：刘克贵[1] 王京平[1] 王振海[1] 赵善娜[2] 

机构地区：[1]山东省烟台市烟台山医院骨科,264001 [2]烟台市烟台山医院化验室

出　　处：《骨与关节损伤杂志》2002年第6期428-429,共2页The Journal of Bone and Joint Injury

摘　　要：目的　通过关节成形术中收集的标本进行细菌学检查 ,评估手术区域的污染情况 ,确定微生物的种属 ,明确污染的途径 ,为临床手术过程的无菌术改进提供依据 ,以降低感染率。方法　从 80例髋、膝关节成形术中收集的标本进行细菌培养。结果　吸管尖部污染率为 17 1% ,手术灯把手为 12 7% ,皮刀为 10 8% ,深部刀片为 4 0 % ,准备手术过程中所戴手套尖部31 3%被污染 ,术中收集袋中的注射器 2 2 9%培养出细菌 ,手术结束时的手术衣前部 18 9%被污染 ,8 8%的筋膜缝合针有污染。 78%的微生物为金黄色葡萄球菌。两年后的随访中 ,发现一例深部感染 ,证实为葡萄球菌感染。结论　关节成形手术中所用物品可污染细菌 。Objective To assess the frequency of contamination in operative areas and to identify the organisms involved in order to formulate pathways of contagion and suggest changes in conventionally accepted practice.Methods We collected samples from 80 primary hip and knee arthroplasties and carried out bactreial culture.Results These showed rates of contamination were 17 1% for the sucker tip,12 7% for light handles,10 8% for skin knives and 4 0% for the inside knives used during surgery,and 31 3% of gloves used for preparation.Of the syringe samples taken from the collection bags used during arthroplasty,22 9% grew bacteria,also,18 9% of theatre gowns were contaminated at the end of the operation. Contamination was found in 8 8% of the needles used during closure of the fascia,overall,78% of the organisms grown were staphylocaccus aueus.One cases of deep infection occurred on the followed-up time of postoperative two years. The organism was identified as a contaminant.Conclusion All surgical operations on arthroplasties have the potentials for contamination,and the equipment used can harbour bacteria.

关 键 词：关节成形术 细菌污染 观察 

分 类 号：R687.4[医药卫生—骨科学]