2%葡萄糖酸氯己定术前消毒沐浴在颅脑肿瘤切除术患者中的应用效果

Effect of preoperative disinfection bathing with 2% chlorhexidine gluconate on patients undergoing craniocerebral tumorectomy

  • 摘要:
    目的 探索术前使用2%葡萄糖酸氯己定消毒沐浴干预措施对于预防颅脑肿瘤切除术手术部位感染(SSI)的效果,明确颅脑肿瘤切除术SSI的危险因素。
    方法 选取2021年7月-2023年12月中国医学科学院肿瘤医院神经外科住院行颅脑肿瘤切除术患者为研究对象,采用随机对照研究设计,将纳入的患者按照随机数字表法分为干预组和对照组,各180例,比较手术备皮后使用含2%葡萄糖酸氯己定清洗消毒液进行沐浴是否能降低SSI发生率。同时收集患者的基础信息、围术期抗菌药物使用情况、手术信息、术后情况、SSI情况等临床资料进行统计描述,采用卡方检验及logistic回归模型分析SSI的危险因素。
    结果 干预组颅脑肿瘤切除术SSI发生率6.11%(11/180),对照组17.22% (31/180),两组比较差异有统计学意义(P=0.002);多因素logistic回归显示,手术时长(>335 min)(OR=5.612, 95%CI:2.623~12.009, P<0.001)、颅脑手术史(OR=3.554, 95%CI:1.029~12.277, P=0.045)是SSI的危险因素,术前使用2%葡萄糖酸氯己定消毒沐浴(OR=0.229, 95%CI:0.104~0.501, P<0.001)是SSI的保护性因素。
    结论 术前使用2%葡萄糖酸氯己定消毒沐浴干预措施可降低颅脑肿瘤切除术SSI的发生率;而手术时长>335 min、颅脑手术史会增加SSI风险。

     

    Abstract:
    OBJECTIVE To explore the effectiveness of preoperative disinfection bathing intervention with 2% chlorhexidine gluconate in preventing surgical site infection (SSI) in patients undergoing craniocerebral tumorectomy and to identify the risk factors for SSI in craniocerebral tumorectomy.
    METHODS Patients who underwent craniocerebral tumorectomy in the department of neurosurgery at the Cancer Hospital Chinese Academy of Medical Sciences from Jul. 2021 to Dec. 2023 were selected as the study subjects. A randomized controlled study design was adopted, and the included patients were randomly divided into an intervention group and a control group, with 180 cases in each group, based on the random number table method. The study explored whether bathing with a 2% chlorhexidine gluconate cleaning and disinfecting solution after surgical skin preparation could reduce the incidence of SSI. Clinical data, including basic patient information, perioperative antibacterial drug use, surgical information, postoperative conditions and SSI status, were collected for statistical description. The chi-square test and logistic regression model were used to analyze the risk factors for SSI.
    RESULTS The incidence of SSI after craniocerebral tumorectomy in the intervention group was 6.11% (11/180), while that in the control group was 17.22% (31/180), with a statistically significant difference between the two groups (P=0.002). Multivariate logistic regression analysis revealed that prolonged surgical duration (>335 min) (OR=5.612, 95% CI: 2.623-12.009, P < 0.001) and a history of craniocerebral operation (OR=3.554, 95% CI: 1.029-12.277, P=0.045) were risk factors for SSI, whereas preoperative disinfection bathing with 2% chlorhexidine gluconate (OR=0.229, 95% CI: 0.104-0.501, P < 0.001) was a protective factor against SSI.
    CONCLUSION Preoperative disinfection bathing intervention with 2% chlorhexidine gluconate can reduce the incidence of SSI in patients undergoing craniocerebral tumorectomy, while prolonged surgical duration (> 335 min) and a history of craniocerebral operation will increase the risk of SSI.

     

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