心血管介入手术时长与手套洁净程度相关性的真实世界研究

A real-world study on correlation between duration of cardiovascular interventional surgery and cleanliness of gloves

  • 摘要: 目的 分析心血管介入手术时长与术者佩戴无菌外科手套外表面微生物阳性的增减变化规律,探讨介入手术超过一定时长,术者是否有必要更换无菌手套,从而降低医院感染风险,保护患者安全。方法 随机抽取中国医学科学院阜外医院开展的90台次心血管介入手术,在不同的手术时点对术者佩戴无菌外科手套外表面进行微生物采样,分析微生物污染检出情况。结果 本次研究纳入的心血管疾病介入手术90台次,共采集样本98份,其中7例手术用时较长,进行多时间点采样(6例采样2次、1例采样3次),并将手术时长≤2 h归为Ⅰ组,>2 h归为Ⅱ组。Ⅰ组采样阳性率为4.00%(2/50),Ⅱ组采样阳性率为16.67%(8/48),两组比较有统计学差异(P=0.049); 手套外表面检出菌主要为凝固酶阴性葡萄球菌和枯草芽孢杆菌等定植或条件致病菌。结论 操作时长>2 h的介入手术术者佩戴无菌外科手套外表面细菌检出阳性率高于≤2 h的介入手术,建议手术时长较长的情况下,术中更换无菌外科手套。

     

    Abstract: OBJECTIVE To analyze the association of variation patterns of positive rates of microorganisms on the outer surfaces of sterile surgical gloves worn by operators with the duration of cardiovascular interventional procedures and explore the necessities of changing the sterile gloves when the interventional procedures exceed a certain time period so as to reduce the risk of health care-associated infections (HAIs) and protect the patients. METHODS Totally 90 times of cardiovascular interventional procedures that were performed in Fuwai Hospital, Chinese Academy of Medical Sciences were randomly selected. Microbial sampling was conducted on the outer surface of the sterile surgical gloves worn by the operators at different time points during the surgical procedures. The status of microbial contamination and positive rates of microorganisms were observed. RESULTS A total of 90 times of cardiovascular interventional procedures were included in the study, and 98 samples were collected. Totally 7 surgical procedures took relatively long durations, the samples were collected at multiple time points (2 times for 6 cases, 6 times for 1 case). The surgical procedures with the duration no more than 2 hours were assigned as the group Ⅰ, and the surgical procedures with the duration more than 2 hours were assigned as the group Ⅱ. The positive rate of samples was 4.00%(2/50)in the group Ⅰ, 16.67%(8/48)in the group Ⅱ, and there was significant difference between the two groups(P=0.049). Coagulase-negative Staphylococcus and Bacillus subtilis were the predominant colonized or opportunistic pathogens isolated from the outer surfaces of the gloves. CONCLUSION As for the interventional produces with the duration more than 2 hours during which the operators wear sterile surgical gloves and the positive rate of bacteria on outer surfaces of the gloves is higher than the interventional procedures with duration no more than 2 hours, it is recommended that the sterile surgical gloves should be changed during the procedures under the condition of long operation duration.

     

/

返回文章
返回