创伤骨科手术中手套破损情况分析及对策

An Analysis of Medical Gloves Breaking in Traumatic Orthopedics Surgery and the Coping Strategy

目的探讨创伤骨科手术中手套破损的现状,为防止医护人员和患者术中因手套破损而感染提出对策。方法对2007年12月—2008年3月351名(702人次)创伤骨科手术的操作医生和护士术中手套的破损情况进行调查,统计分析手套破损率、部位、原因、破损发现的方式。将数据输入Excel软件进行处理,对资料进行统计学描述。结果702人次中245人次发生手套破损,占34.9%,其中210人次主刀医生中101人次发生手套破损,占48.1%,210人次一助医生中84人次发生手套破损,占40.0%,210人次洗手护士中48人次发生手套破损,占22.9%,72人次二助医生中12人次发生手套破损,占16.7%;手套破损以掌侧手指多见,手指破损240只占89.2%,主要为拇指、食指、中指,其中食指最多占82.0%;术后肉眼发现的手套破损数最少,共21只占7.8%,大多数发现手套破损时间为手术开始后30min,占30%～50%,术后加压检查时发现手套破损也较多;检查手套发现被骨碎片、克氏针、缝针、刀片等利器损伤占47.9%。结论为预防医患双方交叉感染,创伤骨科手术的操作者应戴双层手套,尤其是主刀医生必须戴双层手套,术中一旦有手套破损的可能应及时再刷手更换手套。

Objective To explore the status quo of the breaking of medical gloves in traumatic orthopedics surgeries, and thus to formulate the coping strategies for preventing the infections to the medical personnels and patients owing to the incidence of the gloves breaking. Methods An investigation was made of the incidence of glove breaking with 351 doctors and nurses involved in the traumatic orthopedics surgeries （702 person times） between Dec. 2007 and Mar. ：2008. A record was made of the rate, locations and causes of the breakings, and how the breakings were found. Then the obtained data were processed with Excel for statistical description. Results Among the 702 person times surgeries, 245 had glove breakings, accounting for 34.9%. Of those with the glove damage, 101 person times（48.1%） were with the doctor performing the surgeries, 84 （40.0%）, 48 （22.9%）, 12 （16.7%） were with the first assistant doctors, scrub nurses and the second assistant doctors, respectively. The breakings mostly occurred at the thumb, index finger and middle finger, with those at the index finger accounting for 82.0%. The breakings found with the naked eyes were the fewest, numbering 21 and accouting for 7.8%, with more being found at the post-surgery pressured checking. Most of findings of the breakings were 30 mins after the beginning of the surgeries, acconting for 30% to 50%. The breakings caused by sharp things such as fractured bone pieces, Kirschner wires, suture needles, blades accounted for 47.9%. Conclusion In order to prevent the medical- patient cross infections, the medical personnels involved in traumatic orthopedics surgeries, especially the doctors performing the surgeries, should wear double-layer medical gloves, and in case of possibility of breaking, the orginal ones should be changed.