口腔正畸治疗期间医院感染的临床分析

Clinical analysis of risk factors for nosocomial infections during orthodontic treatment

目的分析口腔正畸治疗期间医院感染的危险因素,制定针对性的治疗对策,降低医院感染率。方法对医院2008年1月-2013年1月口腔正畸治疗的1 761例患者资料进行回顾性分析,对感染原因、临床表现及治疗结果进行分析。结果 1 761例口腔正畸治疗患者治疗期间乙型肝炎病毒感染11例,感染率为0.62%;治疗后61~90d发病率最高,占36.36%,发病时间30d^6个月;操作中医师与护士手卫生菌落数均高于国家卫生部规定的10CFU/cm2标准,口腔器械盘菌落数与使用时间呈正相关,使用时间越长,菌落数越高,其差异有统计学意义(P<0.05);正畸材料及器械消毒前菌落数均超标,消毒后达标;经对症及调节免疫治疗后,所有临床体征消失,疗程最短42d,最长86d,平均疗程(66.3±10.5)d。结论口腔正畸治疗期间的医院感染不容忽视,应制定严格的消毒防护措施,以降低医院感染率。

OBJECTIVE To analyze the risk factors for nosocomial infections during the orthodontic treatment and put forward targeted treatment countermeasures so as to reduce the incidence of nosocomial infections .METHODS A total of 1 761 patients who underwent the orthodontic treatment in the hospital from Jan 2008 to Jan 2013 were enrolled in the study ,then the clinical data of the patients were retrospectively analyzed ,the causes of infections , clinical manifestations ,and therapeutic effect were observed .RESULTS Of the 1 761 patients undergoing the or-thodontic treatment ,11 were infected with hepatitis B virus ,with the infection rate of 0 .62% ;after the treatment for 61-90 days ,the morbidity was the highest （36 .36% ） ,with the onset time varying from 30 days to 6 months . The bacterial colony counts of hand hygiene of the physicians and nurses were higher than the standard of 10 CFU/cm2 ,which was specified by the Ministry of Health ,the bacterial colony count on the dental instrument dish was positively correlated with the use time ,the longer the use time ,the higher the bacterial colony counts were ,and there was significant difference（P〈 0 .05） .The bacterial colony counts on the Orthodontic materials and equip-ments exceeded the standard but met the standard after the disinfection .All the clinical signs disappeared after the symptomatic and immunomodulatory treatment ,and the treatment course was the shortest of 42 days ,86 days the longest ,with the mean treatment course of （66 .3 ± 10 .5） days .CONCLUSION It is suggested that the nosocomial infections during the orthodontic treatment can not be ignored ,and the rigid disinfection and prevention measures should be formulated so as to reduce the incidence of nosocomial infections .