介入手术部位感染危险因素分析与对策

Analysis and countermeasures of risk factors for interventional operation site infection

目的分析介入手术部位感染危险因素,探讨相应的预防控制对策,提高介入手术部位医院感染管理水平。方法回顾性分析2008年2月至2011年2月商丘市第一人民医院实施介入手术患者143例临床资料,按其手术后是否发生感染分为感染组和对照组。感染组36例,其中男24例,女12例,平均年龄(49.2±9.3)岁;对照组108例,其中男78例,女30例,平均年龄(50.1±8.9)岁;且两组患者具有可比性。统计两组之间实施手术的医护人员年资、手术时间、手术室环境的差异,并采用统计学软件对数据进行处理。结果两组患者手术时间越长感染危险越高,实施手术医护人员的年资越低,感染危险越高,差异具有高度统计学意义(P<0.01)。术前手术室的空气、物体表面、医务人员的外科手消毒及所使用的皮肤消毒液的细菌监测结果显示:菌落数越高,感染危险越高,两组间差异具有统计学意义(P<0.05)。结论实施介入手术的医护人员的年资低、无菌操作不严、手术时间长、外科手消毒不规范是导致患者感染的危险因素,加强介入手术部位感染控制的系统管理,是降低介入手术后感染的关键。

Objective To analyze the risk factors for infection in interventional operation,and discuss the corresponding countermeasures of prevention and controlling, and improve the infection management level in interventional operation. Methods Clinical data of 143 patients underwent interventional operation were retrospectively analyzed in Shangqiu First People’s Hospital from February 2008 to February 2011. The patients were divided into infected group and control group according to whether infection occurred after the operation. The infected group had 36 cases,including 24 male cases and 12 female cases,and mean age was （49.2 ± 9.3） years. There were 108 cases in the control group,including 78 male and 30 female,the mean age was （50.1 ±8.9） years. Medical personnel qualification,operation time,operating room environment were compared between the two groups,and the statistical software was used for data processing. Results The patients prolonged the time of surgery,the risk of infection would be higher and this would also happened if surgery medical personnel ’s qualification was lower. A highly significant difference can be seen （P0.01） . The monitoring results of air quality in the operating room, surfaces,medical staff of surgical hand disinfectant,and the skin disinfectant reveal that the higher bacteria in the colony count,the higher risk it had,the statistic difference between the two groups was significant （P0.05） . Conclusions Staff with low qualification in interventional operation,long operation time, undemanding sterile manipulation,and non-stand surgical hand disinfection were the main factors that result in infection of patients. Therefore, strengthening the systematical management of infection control in interventional operation would be the key to reduce the infection after interventional operation.