两种皮肤准备方法在颅脑择期手术中的效果比较
摘要
目的探讨两种皮肤准备方法在颅脑择期手术中的效果比较。方法 2014年3月至2015年7月,采用临床随机对照的研究方法,将符合纳入标准并同意参与本研究的1 041例颅脑择期手术患者随机分为试验组和对照组,试验组525例,对照组516例。对照组采用传统皮肤准备方法:手术当日理发师用剃刀剃除患者头部全部毛发,再用肥皂清洁头部。试验组采用皮肤准备新流程:术前2d,每日用洗发膏清洁患者头部,再用洗必泰搓揉头部5min,清水洗净;手术当日,主管医生在手术室术前即刻用理发剪推除患者手术部位毛发。研究助理于患者出院当天收集患者满意度,于患者术后第30天通过电话随访收集其手术部位感染信息;其余数据从医院信息系统提取。结果试验组与对照组在手术部位感染率、平均住院日、患者满意度3个方面差异有统计学意义(P<0.05)。结论术前皮肤准备新方法可降低颅脑择期手术患者手术部位感染率、缩短平均住院日、提升患者满意度。
引文
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[12]王凤霞,周玲,梁冬琴.手术部位感染的危险因素调查分析.中华医院感染学杂志,2013,23(17):4154-4155.
[13]MANGRAM AJ,HORAN TC,PEARSON ML,et al.Guideline for prevention of surgical site infection,1999.Infect Control Hosp Epidemiol,1999,20(4):250-278.
[14]SAIMAN L,SIEGEL JD,LIPUMA JJ,et al.Infection prevention and control guideline for cystic fibrosis:2013update.Infect Control Hosp Epidemiol,2014,35(1):1-67.doi:10.1086/676882.
[15]吴杰.不剃发应用于非感染性头皮肿块术前备皮的临床研究.中华护理杂志,2015,44(6):339-401.
[2]李子榕,孙爽,刘笛.开颅手术患者术前皮肤准备集束化干预策略的效果研究.中华医院感染学杂志,2015,25(19):4481-4485.
[3]吴雪琼,陈丽,邬利萍,等.手术室内备皮对预防手术部位感染的影响.中华医院感染学杂志,2013,23(16):3896-3900.
[4]屠芳兰,贾彦霞,刘丽荣.普外科患者不同备皮方法对术后感染的影响研究.中华医院感染学杂志,2015,25(16):3771-3773.
[5]MEHTA JA,SABLE SA,NAGRAL S.Updated recommendations for control of surgical site infections.Ann Surg,2015,261(3):65-65.
[6]ALEXANDER JW,SOLOMKIN JS,EDWARDS MJ.Updated recommendations for control of surgical site infections.Ann Surg,2011,253(6):1082-1093.
[7]GARIBALDI RA.Prevention of intraoperative wound contamination with chlorhexidine shower and scrub.J Hosp Infect,1988,11(1):5-9.
[8]NISHIHARA Y,KAJIURA T,YOKOTA K,et al.Evaluation with a focus on both the antimicrobial efficacy and cumulative skin irritation potential of chlorhexidinegluconate alcohol-containing preoperative skin preparations.Am J Infect Control,2012,40(10):973-978.
[9]SEROPIAN R,REYNOLDS BM.Wound infections after preoperative depilatory versus razor preparation.Am J Surg,1971,121(3):251-254.
[10]TANNER J,WOODINGS D,MONCASTER K.Preoperative hair removal to reduce surgical site infection.Cochrane Database Syst Rev,2006,19(3):CD004122.doi:10.1002/14651858.
[11]TANNER J,NORRIE P,MELEN K.Preoperative hair removal to reduce surgical site infection.Cochrane Database Syst Rev,2011,9(11):CD004122.doi:10.1002/14651858.
[12]王凤霞,周玲,梁冬琴.手术部位感染的危险因素调查分析.中华医院感染学杂志,2013,23(17):4154-4155.
[13]MANGRAM AJ,HORAN TC,PEARSON ML,et al.Guideline for prevention of surgical site infection,1999.Infect Control Hosp Epidemiol,1999,20(4):250-278.
[14]SAIMAN L,SIEGEL JD,LIPUMA JJ,et al.Infection prevention and control guideline for cystic fibrosis:2013update.Infect Control Hosp Epidemiol,2014,35(1):1-67.doi:10.1086/676882.
[15]吴杰.不剃发应用于非感染性头皮肿块术前备皮的临床研究.中华护理杂志,2015,44(6):339-401.