两种外科洗手方法消毒效果的临床研究

Clinical Research of Two Types of Surgical Hand-washing on Disinfection Effect

目的比较揉搓清洁洗手法与刷洗清洁洗手法的消毒效果,手掌面与手背面采样培养效果,为规范外科洗手方法提供依据。方法选取2015年3-5月四川医科大学附属第一医院门急诊手术室医护人员共100人,按照随机数字表法分为揉搓清洁洗手组(A组)和刷洗清洁洗手组(B组),每组50人。所有人员使用相同手清洁剂和外科手消毒剂,洗手消毒后对手掌面与手背面进行采样培养,检测细菌菌落数,并调查医护人员对两种洗手方法的满意度。结果所有采样培养细菌菌落数≤5CFU/cm2,共有10个样本培养出菌落数,A组9个(手掌面4个,手背面5个),B组1个(手背面),A组菌落培养阳性例数多于B组,差异有统计学意义(P<0.05),手掌面与手背面采样培养阳性例数比较,差异无统计学意义(P>0.05)。揉搓清洁洗手法满意度显著高于刷洗清洁洗手法,差异有统计学意义(P<0.05)。结论揉搓清洁洗手法与刷洗清洁洗手均可达到消毒效果,但前者培养菌落阳性例数多于后者;手掌面与手背面均可作为外科洗手细菌培养的采样部位。

Objective To compare the disinfection effect of two types of surgical hand-washing：hand rubbing and hand scrubbing,and to compare the cultivation efficacy of sampling on palm of hand and the back of hand,so as to provide the basis for the standard of surgical hand washing.Methods From March to May 2015,a total of100 surgeons and nurses in our hospital were randomly divided into 2groups：hand rubbing group（group A）and hand scrubbing group（group B）,50 in each group,with the same liquid skin cleaner and surgical hand disinfectant.The samples on the palm of hand and the back of hand were collected after hand washing and cultured for the counts of bacterial colonies and investigated the satisfaction degree of hand rubbing and hand scrubbing of surgeons and nurses.Results The counts of bacterial colonies of all samples were not more than 5 CFU/cm^2.The bacterial colonies were detected in 10samples：9samples in group A（4from palm side,5from the back of hand）,and 1in group B（the back of hand）,the number of positive samples in group A was more than group B（P〈0.05）.The number of positive samples had no significant difference between palm of hand and back of hand（P〉0.05）.The satisfaction degree of hand rubbing was significantly higher than hand scrubbing（P〈0.05）.Conclusion The two types of surgical hand-washing（hand rubbing and hand scrubbing）could achieve good disinfection effect,but the counts of bacterial colonies in hand rubbing are more than hand scrubbing.Palm of hand and back of hand could be sampled for bacterial culture in surgical hand-washing.