不同手卫生消毒方法对外科手术切口感染率的影响

Effects of different hand hygiene methods on the infection rate of surgical operation incision

目的观察不同手卫生方法对外科手术切口感染率的影响。方法选择外科医护人员120名,实验组分别为醋酸氯己消毒剂揉搓法、酒精消毒剂搓揉法和含抗菌成分洗手液洗手法,同时以常规的肥皂洗手法洗手作为对照组,观察各组人员手部细菌菌落数。进行回顾性分析,比较各组感染率的差异。结果醋酸氯己消毒剂揉搓法、酒精消毒剂搓揉法、含抗菌成分洗手液洗手法及常规肥皂洗手法消毒合格率分别为83.33%、96.67%、80.00%、73.33%,均未检出致病菌。在手卫生上,酒精消毒剂搓揉法高于常规肥皂洗手法(χ2=4.71,P<0.05)。在感染率上,醋酸氯己消毒剂揉搓组、酒精消毒剂搓揉组、含抗菌成分洗手液洗手组及常规肥皂洗手组在手卫生前后手术切口感染率分别为14.29%、7.14%、15.71%、25.71%,酒精消毒剂搓揉法组的术后切口感染率显著低于常规肥皂洗手组(χ2=8.79,P<0.05)。结论酒精消毒剂搓揉法为目前应该推荐的外科切口护理的首选方法。

Objective To observe the effects of different hand hygiene methods on the infection rate of surgical operation incision. Methods One hundred and twenty surgical medical staffs were selected in this study. The hand washing with antibacterial ingredients,the hand rubbing with alcohol disinfectant and the hand rubbing with chlorhexidine acetate disinfectant were set as the experimental groups,which were then compared with the regular soap hand washing. The bacteria colonies on the medical staffs hands of the 4 groups were observed to analyze the incidence of wound infection after surgical operation,and then the difference of the infection rates among the 4 groups was compared. Results The qualified rates of the hand washing with antibacterial ingredients,the hand rubbing with alcohol disinfectant,the hand rubbing with chlorhexidine acetate disinfectant and the regular soap hand washing group were 83. 33%,96. 67%,80. 00%,73. 33%,respectively. No pathogenic bacteria were detected in all the 4 groups. There was significant difference between the hand rubbing with alcohol disinfectant group and the regular soap hand washing group in hand hygiene（ χ^2= 4. 71,P〈 0. 05）. While the surgical incision infection rates of the hand washing with antibacterial ingredients group,the hand rubbing with alcohol disinfectant group,the hand rubbing with chlorhexidine acetate disinfectant group and the regular soap hand washing group were 14. 29%,7. 14%,15. 71%,25. 71%,respectively. The surgical incision infection rate of the hand washing with alcohol disinfectant group was distinctly lower than that of the regular soap hand washing group（ χ^2= 8. 79,P〈 0. 05）. Conclusion The hand rubbing with alcohol disinfectant can effectively control the hand hygiene conditions and should be recommended for the current.