两种消毒方法对带肠造口腹部切口感染影响的观察

The Observation of Effects of Colostomy Abdominal Surgical Site Infection with Two Disinfection Methods

目的比较两种不同皮肤消毒方法对带肠造口腹部手术切口感染的影响效果。方法选取带肠造口行腹部手术的患者280例,随机分为实验组和对照组,每组140例。实验组分两次消毒,首先在造口周围消毒后用纱粒及手术薄膜将其密封贴好,再根据常规消毒方法及范围消毒腹部。对照组用常规方法及范围消毒腹部,在肠造口处改用碘伏消毒,纱布覆盖造口,缝合并固定纱布于皮肤。实验组的铺巾方法与对照组相同。对2组手术切皮前及手术结束后缝合皮肤前的切口周围皮肤进行采样,并进行细菌培养,比较2组在一般资料、手术类型、细菌培养结果、手术时间、抗生素应用天数、术后切口感染率之间的差异。结果 2组在一般资料、手术类型、手术时间、抗生素应用天数等方面差异无统计学意义(P>0.05);细菌培养结果切皮前2组均为0,缝皮前实验组阳性例数5例,对照组22例,2组间比较差异有统计学意义(P<0.01)。实验组发生切口感染3例,感染率2.14%,对照组发生切口感染11例,感染率7.85%,差异有统计学意义(P<0.05)。结论改良后的分次消毒方法能有效降低带造口腹部切口感染率,值得推广。

Objective To compare the effects of colostomy abdominal surgical site infection with two disinfection methods. Methods We selected 280 patients undergoing abdominal surgery with enterostomy as the study subjects. The subjects were divided into the experimental group（ 140 cases） and the control group（ 140 cases） randomly. The experimental group was disinfected two times. Firstly, disinfect the stoma and then seal it with gauze and surgical film. Second!y disinfect the abdomen with the routine disinfection method and range. For the control group, disinfect the abdomen with conventional method and scope of disinfection,then disinfect the colostomy with iodophor and gauze covering stoma, The control group was treated with conventional method and scope of disinfection in the abdomen and iodophor disinfection around the colostomy ,with gauze covering the stoma and needle fixed gauze on the skin. The towel laying methods of two groups are the same. The samples for bacterial culture ＇of two groups were collected in the skin around the incision before cutting the skin and before suturing the skin. The differ- ences between the two groups in general information, operation types, bacterial culture results, operation time, antibiotic usage days and postop- erative infection rate were compared. Results There was no significant difference in general information, operation types, bacterial culture re- suits, operation time and antibiotic usage days before cutting the skin between the two groups. There were 22 cases of bacterial culture before suturing the skin in the control group and 5 cases in the experimental group were positive ,with significant difference between the two groups（ P 〈 0. O1 ）. Three patients occurred surgical site infection in the experimental group with the infection rate of 2.14% and eleven patients in the control group with the infection rate of 7.85%. The difference between the two groups was statistically significant（ P 〈 0.05 ）. Conclusion The improved disinfection method is effective in preventing colostomy abdominal surgical site infection and deserves to be widely promoted.