层流手术室手术患者院内感染的危险因素及其对策分析
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摘要
目的调查影响层流手术室(laminarflow operating rooms,LFOR)手术患者院内感染的危险因素,并分析其对策。方法选取2012年8月—2018年8月期间在我院LFOR开展手术的600例患者纳入研究,依据是否发生院内感染分为感染组与非感染组,比较2组患者一般资料、手术情况,并分析影响患者感染的危险因素。结果 600例患者中,24例(4.00%)发生院内感染。感染组患者年龄≥60岁,合并糖尿病、高血压,急诊手术,手术时间≥2 h,II类切口,术中输血,术中有设备搬动比例明显高于非感染组(P均<0.05);Logistic回归分析显示,年龄≥60岁、有合并症、急诊手术、手术时间≥2 h、II类切口、术中输血、术中有设备搬动均为患者院内感染的危险因素。结论 LFOR手术患者院内感染危险因素主要为高龄、有合并症、急诊手术、手术时间长、II类切口、术中输血、术中有设备搬动等,临床可针对这些因素采取相应预防对策,以降低感染风险。
Objective To investigate the risk factors of nosocomial infections of surgical patients in laminar flow operating room(LFOR) and analyze the countermeasures. Methods A total of 600 patients who underwent operations in the LFOR of our hospital from August 2012 to August 2018 were enrolled in the study. They were divided into the infected group and the uninfected group according to the presence of nosocomial infection. The general data and operations were compared between the 2 groups and the risk factors for infections were analyzed. Results Among the 600 patients, 24 cases(4.00%) were infected. The proportions of patients at the age of ≥60 years, complicated with diabetes or hypertension, emergency operation, operation time ≥ 2 h, type II incision, intraoperative blood transfusion and intraoperative equipment movement in the infected group were significantly higher than those in the uninfected group(P <0.05). Logistic regression analysis showed that age of ≥ 60 years, complications, emergency operation, operation time ≥ 2 h, type II incision, intraoperative blood transfusion and intraoperative equipment movement were risk factors for nosocomial infections of patients in LFOR. Conclusions The risk factors for nosocomial infections of patients in LFOR mainly include advanced age, complications,emergency operation, long operation time, type II incision, intraoperative blood transfusion and intraoperative equipment movement.Clinical preventive measures can be taken against these factors to reduce the infection risk.
Objective To investigate the risk factors of nosocomial infections of surgical patients in laminar flow operating room(LFOR) and analyze the countermeasures. Methods A total of 600 patients who underwent operations in the LFOR of our hospital from August 2012 to August 2018 were enrolled in the study. They were divided into the infected group and the uninfected group according to the presence of nosocomial infection. The general data and operations were compared between the 2 groups and the risk factors for infections were analyzed. Results Among the 600 patients, 24 cases(4.00%) were infected. The proportions of patients at the age of ≥60 years, complicated with diabetes or hypertension, emergency operation, operation time ≥ 2 h, type II incision, intraoperative blood transfusion and intraoperative equipment movement in the infected group were significantly higher than those in the uninfected group(P <0.05). Logistic regression analysis showed that age of ≥ 60 years, complications, emergency operation, operation time ≥ 2 h, type II incision, intraoperative blood transfusion and intraoperative equipment movement were risk factors for nosocomial infections of patients in LFOR. Conclusions The risk factors for nosocomial infections of patients in LFOR mainly include advanced age, complications,emergency operation, long operation time, type II incision, intraoperative blood transfusion and intraoperative equipment movement.Clinical preventive measures can be taken against these factors to reduce the infection risk.
引文
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[11]刘建新,苏磊,韩伟,等.手术室层流通风系统与感染率关联性问题的研究进展[J].中国医疗设备,2016,31(12):80-81.
[12]安振平,孙兰兰,高琼,等.手术室层流系统通气对手术切口感染防护的意义[J].中国消毒学杂志,2016,33(1):65-66.
[2]Vij SC,Kartha G,Krishnamurthi V,et al.Simple operating room bundle reduces superficial surgical site infections after major urologic surgery[J].Urology,2017,195(4):e239-e240.
[3]郝学安,姜传新,张书岭,等.济宁市医院洁净手术室综合性能评定分析[J].中华医院感染学杂志,2017,27(19):4549-4552.
[4]张杰,刘军,杜俊,等.不同采样方法监测层流洁净手术室空气质量结果比较[J].中国消毒学杂志,2017,34(9):814-816.
[5]Shallwani H,Shakir HJ,Aldridge AM,et al.Mandatory change from surgical skull caps to bouffant caps among operating room personnel does not reduce surgical site infections in class I surgical cases:a single-center experience with more than 15 000 patients[J].Neurosurgery,2017,81(6):e71-e72.
[6]范宇召,田利静.层流手术室无菌灯柄消毒效果与影响因素[J].中国消毒学杂志,2017,34(6):584-585.
[7]鲁飞,崔树玉.层流洁净手术室环境医院感染控制措施[J].中国消毒学杂志,2016,33(5):478-481.
[8]赵国良,张在保.手术患者发生切口感染的手术室相关因素分析及护理对策[J].基因组学与应用生物学,2016,6(8):1912-1915.
[9]刘晓凤,邓露,申海艳,等.手术室层流通风系统的国内外应用现状[J].中华医院感染学杂志,2017,27(12):2876-2880.
[10]孟宪惠,左志刚,宋德刚,等.手术室导致骨科无菌切口手术感染的影响因素及干预对策[J].中华保健医学杂志,2016,18(4):327-328.
[11]刘建新,苏磊,韩伟,等.手术室层流通风系统与感染率关联性问题的研究进展[J].中国医疗设备,2016,31(12):80-81.
[12]安振平,孙兰兰,高琼,等.手术室层流系统通气对手术切口感染防护的意义[J].中国消毒学杂志,2016,33(1):65-66.