生理盐水联合酒精应用的不同方式对皮试消毒的效果分析

An Analysis on Effect of Different Application Ways of Normal Saline plus Alcohol on Skin Test

目的：探讨运用0．9％氯化钠（即生理盐水）联合75％乙醇应用的不同方式对皮试区皮肤消毒效果的研究。方法：选取某院2013年1～12月的门诊输液需进行过伤风抗病毒素过敏皮试的患者共600例，随机分为擦拭组和擦喷组。擦拭组用0．9％氯化钠涂擦后应用75％酒精以同样的方法消毒，然后进行皮试；擦喷组先用75％酒精用以上述同样的方法消毒后用装有0．9％氯化钠的喷瓶对着乙醇擦拭部位进行喷射，后用无菌棉签擦拭干净消毒部位后进行皮试，20min后对比观察两组皮试后假阳性率、用药后的感染率及出现过敏反应和两组患者消毒区的灭菌数量的比较情况。结果：擦拭组患者和擦喷组患者出现的假阳性率分别为0．7％和3．3％，（P＜0．05），两组患者均无1例出现注射部位的皮肤感染和过敏；而两组患者用药后的灭菌数，擦拭组低于擦喷组，对比有显著差异（ P＜0．05）。结论：利用生理盐水联合酒精的擦拭和喷雾的方法在皮试消毒的应用中安全适用，降低了由皮肤消毒剂引起的假阳性率，减轻了患者的痛苦，且方式更加有效，节约卫生资源，减轻工作量，提高临床工作效率。

Objective:To study the sterilizing effect of different application ways of sodium chloride(0 .9% ) plus alcohol(75% ) in the area of skin test .Methods:Select a total of 600 cases of patients who were infused in clinic and has to have a allergy skin test of tetanus antitoxin in some hospital during the period from January 2013 to December , randomly divide them into wiping group and spraying group .The wiping group were wiped with sodium chloride (0 .9% ) firstly ,and then were sterilized with alcohol(75% ) in the same way ,finally took the skin test .The spraying group were sterilized with alcohol(75% ) in the same way above first ,and then were sprayed with the spray bottle containing sodium chloride(0 .9% ) towards the area wiped with alcohol ,dry the sterilized area with sterile swabs and take the skin test .20 minutes later ,Compare and observe the false positive rate after skin test ,infection rate ,the prev‐alence of anaphylactic reaction after medication in the two groups ,sterilizing quantity in sterilized area .Results:False positive rate of the wiping group and spraying group was 0 .7% and 3 .3 respectively (P< 0 .05) .None of them showed any skin infection and allergy in both group .As for the quantity of sterilized bacteria in the two groups after medicating ,the quantity of the wiping group was less than that of spraying group ,the difference was comparatively obvious (P<0 .05) .Conclusion:The safety application of the wipe and spray of normal saline plus and alcohol in the sterilization of skin test lower the false positive rate resulted from skin sanitizer ,alleviate patients'suffering and it is more effective ,saves health resources ,reduces the workload and improves clinical working efficiency .