开颅手术患者术前皮肤准备集束化干预策略的效果研究

Effects of preoperative skin preparation bundle before craniotomy

目的观察术前皮肤准备集束化干预策略的临床效果,为预防颅内感染提供依据。方法选择2011年12月-2012年1月80例开颅手术患者,分为传统组与干预组各40例,以医院神经外科为立足点,应用医学循证学方法,制定术前皮肤准备集束化干预策略,调查备皮时间、皮肤损伤程度等,评价集束化干预策略的近期效果,采用类试验研究方法,对比应用术前皮肤准备集束化干预策略前后患者术后颅内感染发生率,评价集束化干预策略对神经外科开颅手术结局的影响效果。结果择期开颅手术患者应用术前皮肤准备集束化干预策略后,术前备皮操作时间从(18.0±3.9)min缩短至(15.0±1.9)min,集束化干预组77.5%的患者头发去除后皮肤状况优;集束化干预组患者的颅内感染发生率为3.4%明显低于传统组的11.9%,差异有统计学意义(P<0.01)。结论应用术前皮肤准备集束化干预策略,可以提升临床医疗护理质量,提高工作效率,对于预防神经外科开颅手术后颅内感染具有积极意义。

OBJECTIVE To observe the clinical effect of preoperative skin preparation bundle so as to provide refer‐ence for prevention of intracranial infections .METHODS Totally 80 patients undergoing craniotomy during Dec . 2011 to Jan .2012 were selected and were divided into the traditional group and the intervention group with 40 pa‐tients in each group .Based in the department of neurosurgery ,the evidence‐based medicine method was applied to formulate the preoperative skin preparation bundle .The skin preparation time and the damage degree of the skin were investigated to evaluate the recent effect of the intervention bundle .The quasi‐experiment study was conduc‐ted and the incidence of postoperative intracranial infection was compared before and after the implementation of the preoperative skin preparation bundle to evaluate the effect of the intervention buddle on the outcome of craniot‐omy .RESULTS After implementation of the preoperative skin preparation bundle ,the skin preparation time was reduced from （18 .0 ± 3 .9） min to （15 .0 ± 1 .9） min ,77 .5% of the patients had perfect skin condition after remo‐ving hairs .The incidence of intracranial infection was 3 .4% in patients receiving the intervention bundle ,signifi‐cantly lower than 3 .4% in the traditional group （P〈0 .01） .CONCLUSION Preoperative skin preparation bundle , which can improve both the quality of clinical care and work efficiency ,has positive significance for the prevention of intracranial infection after craniotomy .