重症监护病房患者手部带菌不同清洁方法的效果比较

Hand carrier status of ICU patients and comparison of different cleaning methods

目的了解重症监护病房患者手部带菌现状及不同清洁方法的效果，探讨有效的干预措施。方法将2010年7—12月150例重症病房患者随机分为洗手组、消毒手组、擦手组，每组50例，分别在洗手、消毒手、擦手前后采样，比较三组患者在手部清洁前、后带菌量和三组清洁后的效果。结果重症监护病房患者手部带量大、致病菌多。洗手组清洁前后带菌情况比较差异有统计学意义（X^2=56．17，P〈0．01），消毒手组和擦手组清洁前后带菌情况比较差异均有统计学意义（P〈0．01）；不同手部带菌量患者其他物品平均带菌情况比较差异均有统计学意义（X^2=50．917，P〈0．01）；三组患者每日1次清洁与2次清洁手部平均带菌量比较差异均有统计学意义（P〈0．01），每日2次洗手、消毒手的效果明显好于擦手（P〈0．01）。结论重视重症监护病房患者手部清洁，每日2次的洗手或消毒手在控制重症监护病房感染中具有重要作用。

Objective To understand the hand carrier status of ICU patients and comparison of different cleaning methods, and to explore the effective intervening measure. Methods 150 patients received treatments in ICU from July to December in 2010 were randomly divided into washing hand group, disinfecting hand group, wiping hand group, each group had 50 eases, the samples were collected before and after washing hand, disinfecting and wiping hand, the quantity of bacteria in hands were compared before and after cleaning. Results The ICU patients＇ hands had a large quantity bacteria, and more pathogens, the hand carrier status in washing hand group before and after cleaning had statistically different（ X^2 = 56.17 ,P 〈 0. 01 ）, the same to the disinfecting hand group and wiping hand group （ P 〈 0. 01 ）, commodities of patients with different quantity bacteria in hands had the different bacteria carrier status（ X^2 =50.917 ,P 〈0.01 ）. Patients in three groups did hand-washing two times a day had smaller quantity bacteria in hands than did it one time a day（ P 〈0. 01 ）, the effect of washing hand two times a day and disinfecting hand were better than wiping hand （P 〈 0. 01 ）. Condusions Paying attention to patients＇ hand cleaning in ICU,washing hand two times a day or disinfecting hand in ICU plays an important role in controlling infection.