全程无菌干预对无菌手术患者感染的影响

Effect of whole-course aseptic intervention on infection in patients with sterile surgery

  • 摘要: 目的 探讨全程无菌干预对无菌手术患者感染的影响。方法 选取2015年1月-2016年12月于医院接受治疗的1766例无菌手术患者为研究对象,将2015年1-12月接受无菌手术的914例患者设为对照组,手术过程采取常规手术方法,将2016年1-12月接受无菌手术的852例患者为试验组,手术过程中采取全程无菌干预,随访6个月,比较两组患者的感染率;两组规范使用抗菌药物的比例、手术卫生达标及手术室中的空气含菌量,比较两组患者的健康状况调查表的评分,包括生命力/精力、躯体功能、社会功能和精神健康,对发生感染患者进行病原菌鉴定。结果 试验组患者感染率为1.29%(11/852)低于对照组9.52%(87/914)(P<0.001);98例感染患者共培养分离病原菌127株,其中革兰阴性菌69株占54.33%,以铜绿假单胞菌及大肠埃希菌为主;革兰阳性菌51株占40.16%,以金黄色葡萄球菌为主;真菌5株占3.94%、其他2株占1.57%;试验组规范使用抗菌药物817例(95.89%),手术卫生达标839例(98.71%),手术室中的空气含菌量为(0.73±0.17) CFU/m3优于对照组(P<0.05);试验组患者生命力/精力评分,躯体功能的评分,社会功能的评分,精神健康的评分分别为(76.33±11.97),(85.17±16.03),(90.61±13.22),(78.45±14.08)分均高于对照组(P<0.001)。结论 全程无菌干预能有效降低感染率,提高无菌手术患者的术后恢复效果,提高患者的生活质量水平,具有一定的临床价值。

     

    Abstract: OBJECTIVE To explore the effect of whole-course aseptic intervention on the infection of patients with sterile surgery. METHODS A total of 1766 patients with sterile surgery who were treated in our hospital from Jan. 2015 to Dec. 2016 were selected as the study objects. Among them, 914 patients who received sterile surgery from Jan. 2015 to Dec. 2015 were selected as the control group, and were taken a routine surgical procedure, another 852 patients who underwent sterile surgery from Jan. 2016 to Dec. 2016 were set as the experimental group, and the whole process was treated aseptically. After 6 months of follow-up,the infection rates were compared between the two groups, the proportion of antibiotics used in both groups, the proportion of surgical hygiene standards, and the amount of air in the operating room were compared. The scores of the health status questionnaire of the two groups were compared, including vitality / energy, physical function, social function and mental health. The pathogens were detected and identified in the infected patients. RESULTS In the experimental group, the infection rate was 1.29% (11/852), which was significantly lower than 9.52% of the control group (87/914) (P<0.001). A total of 127 strains of pathogens were isolated from 98 infected patients, among which 69 strains of gram-negative bacteria accounted for 53.54%, mainly Pseudomonas aeruginosa and Escherichia coli, 51 strains of gram-positive bacteria accounted for 40.16%, mainly Staphylococcus aureus, 5 strains of fungi accounted for 3.94%, and other 2 strains accounted for 1.57%. There were 817 cases of patients used antibacterial drugs (95.89%), 839 cases achieved satisfactory sanitation of operation (98.71%), and the airborne bacteria in the operating room was (0.73±0.17) CFU/m3 in the experimental group, which were significantly better than those in the control group (P<0.05). The scores of vitality/energy, physical function, social function and mental health in the experimental group were (76.33±11.97), (85.17±16.03), (90.61±13.22) and (78.45±14.08), which were significantly higher than those in the control group (P<0.05). CONCLUSION In the course of the whole process of aseptic intervention can effectively reduce the infection rate, improve the postoperative recovery of patients with aseptic surgery, and improve the quality of life of patients, which have a certain clinical value.

     

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