层流净化手术室对手术感染的预防效果分析

Preventive effect of laminar flow operating room for surgical site infections

目的探讨层流净化手术室(LFOR)对于手术感染(SSI)的预防作用。方法选择2010年2月至2014年2月在本院普通手术室施行腹部手术的患者共1 760例,做为对照组。另外选取同期在本院LFOR接受腹部手术的患者1 730例,做为观察组。比较两组患者术后SSI的发生率。结果两组患者性别、年龄、手术麻醉方式、住院时间、疾病类型、抗菌药物使用和手术时间等一般资料相比,差异均无统计学意义(P均>0.05);术后观察组SSI发生9例,发生率为0.5%,对照组SSI发生23例,发生率为1.3%,两组相比,差异具有统计学意义(χ2=5.942,P<0.05),且两组Ⅰ类切口和Ⅱ类切口SSI发生率相比,差异具有统计学意义(χ2=5.560、P<0.05,χ2=4.432、P<0.05);两组不同手术部位的SSI发生率相比,肝脏(χ2=3.224)、胆囊(χ2=3.502)、脾脏(χ2=4.224)和胃部(χ2=4.273),差异均具有统计学意义(P均<0.05);LFOR在手术进行2 h和3 h的空气菌落数分别为(87.4±5.3)CFU/m3和(74.2±5.1)CFU/m3,普通手术室为(147.9±7.2)CFU/m3和(182.4±5.8)CFU/m3,两组差异均具有统计学意义(2 h:t=33.15、P<0.05,3 h:t=68.63、P<0.05)。结论 LFOR对SSI的发生具有显著的预防作用,且能减少菌落数,保障手术患者的安全。

Objective To investigate the preventive effect of laminar lfow operating room （LFOR） for surgical site infections （SSI）. Methods Total of 1 760 patients accepted abdominal surgery in general hospital operating room from February 2010 to February 2014 were selected as the control group. While 1 730 cases at the same period in LFOR of our hospital for abdominal surgery were selected as the observation group. Incidence of postoperative SSI of the two groups were recorded and compared. Results The difference of general information such as gender, age, surgical anesthesia, hospitalization, type of diseases, use of antibiotics and surgical time between the two groups were not signiifcantly different （P all〉0.05）. There were 9 cases with postoperative SSI, the incidence rate was 0.5%in the observation group, while 23 cases with SSI in the control group, with the rate of 1.3%, the difference between the two groups were signiifcantly different （χ2=5.942, P〈0.05）, and the difference of SSI incidence of classⅠincision and classⅡincision between the two groups were signiifcantly different （χ2=5.560, P〈0.05;χ2=4.432, P〈0.05）. The difference of SSI incidence in different surgical site in the two groups were signiifcant different, wich liver （χ2=3.224）, gallbladder （χ2=3.502）, spleen （χ2=4.224） and stomach （χ2=4.273） （P all〈0.05）. The number of colonies at 2 h and 3 h of surgery beginning were （87.4 ± 5.3） CFU/m3 and （74.2 ± 5.1） CFU/m3 in LFOR, and were （147.9 ± 7.2） CFU/m3 and （182.4 ± 5.8） CFU/m3 in ordinary operating room, with the signiifcant difference （2 h：t=33.15, P〈0.05;3 h：t=68.63, P〈0.05）. Conclusions LFOR has signiifcant preventive effect on SSI, could reduce the number of colonies, and protect the safety of surgical patients.