腹腔镜下胃肠癌根治手术使用的无菌手套忽略性穿孔发生状况及影响因素

Incidence of neglected perforation of sterile gloves during laparoscopic radical resection of gastrointestinal cancer and its influencing factors

  • 摘要: 目的 明确腹腔镜下胃肠癌根治手术使用无菌手套忽略性穿孔(NP)发生状况及影响因素。方法 收集2023年1月-2024年12月于江苏省人民医院宿迁医院行腹腔镜下胃肠癌根治手术使用的无菌外科手套1 198只,统计NP发生情况及部位,对可能导致手套NP的危险因素进行统计学分析。结果 纳入本研究的1 198只腹腔镜下胃肠癌根治手术使用手套,在使用后共检出116只手套发生了NP,NP检出率是9.68%。右手使用手套NP检出率高于左手(P<0.05),最容易发生NP的位置均依次为食指、拇指和手掌心。经单因素和多因素logistic分析筛选出:术中使用CO2气腹压力≥14 mmHg、手套明显被血液或体液污染、术中未及时吸净腹腔内烟雾或出血、患者体质量指数≥28 kg/m2及手术时间≥180 min是导致手套发生NP的危险因素(P<0.05),而使用双层手套是避免NP发生的保护性因素(P<0.05)。结论 腹腔镜下胃肠癌根治手术使用手套的NP发生率较高;术中CO2气腹压力较高、手套明显被血液或体液污染、未及时吸净腹腔内烟雾或出血、患者肥胖及手术时间≥180 min的手套更容易发生NP,而使用双层手套有利于降低NP发生概率。

     

    Abstract: OBJECTIVE To clarify the incidence of neglected perforation (NP) of sterile gloves during laparoscopic radical resection of gastrointestinal cancer and analyze the influencing factors. METHODS A total of 1198 sterile surgical gloves that were used during laparoscopic radical resection of gastrointestinal cancer in Suqian Hospital of Jiangsu Provincial People's Hospital from Jan. 2023 to Dec. 2024 were enrolled in the study. The incidence of NP and the perforated sites of the gloves were statistically analyzed, and statistical analysis was performed for the risk factors for the NP of the gloves. RESULTS Of the 1198 gloves that were enrolled in the study, 116 were detected with NP, with the detection rate 9.68%. The detection rate of NP of the right-hand gloves was higher than that of the left-hand gloves(P<0.05). The sites that were most likely to have NP were as follows: index finger, thumb and palm. The risk factors for NP of the gloves, including intraoperative pneumoperitoneum pressure of CO2 no less than 14 mmHg, clear contamination with blood or body fluid, failed suction of intraabdominal smog or blood in a timely manner, body mass index of the patient no less than 28 kg/m2 and operation duration no less than 180 min, were screened out by the univariate analysis of multivariate logistic analysis (P<0.05); while the use of double-layer gloves was a protective factor for the prevention of NP(P<0.05). CONCLUSIONS The incidence of NP is high among the gloves that are used during laparoscopic radical resection of gastrointestinal cancer. The high pneumoperitoneum pressure of CO2 during surgery, clear contamination with blood or body fluid, failed suction of intraabdominal smog or blood, obesity of the patient and operation duration no less than 180 min are the risk factors for NP, while the use of double-layer gloves may reduce the incidence of NP.

     

/

返回文章
返回