神经外科手术显微镜无菌防护套染菌调查

Bacter contamination survey on the surface of aseptic protective cover during microscope operating in Department of Neurosurgery

目的探讨神经外科手术中使用的显微镜无菌防护套表面细菌污染情况，为实施预防医院感染提供依据。方法选择2015年2-11月神经外科100例手术为对照组，进行常规护理；选择2016年2—12月神经外科100例手术为干预组，器械护士用未沾血液黏液的新无菌注射用水湿巾，及时抹拭术中显微镜无菌套上粘有的血迹，比较干预前后无菌防护套表面细菌监测结果和医院感染的发生率。结果干预组和对照组在显微镜使用的前4h内，细菌检测结果差异无统计学意义（P〉0．05）；至5h和6h时，对照组合格率分别为71％（71／100）和51％（51／100），干预组合格率分别为97％（97／100）和95％（95／100），差异有统计学意义（r=25．15、49．11，P〈0．01）。结论对使用中的手术显微镜无菌防护套表面血迹进行及时清洁，可以有效抑制防护套表面的细菌生长，从而降低神经外科的医院感染率，值得在神经外科手术中推广。

Objective To investigate the bacteriostatic effect of on the surface of bacter contamination survey sterile protective during microscope operating, to provide basis for the implementation of the preventive hospital infection. Methods Routine surgical care was used as the control group（100 cases）. The intervention group（100 cases） was carried out during neurosurgery performed between February and December 2016. Instrument nurses wiped the microscope aseptically with the blood by using new sterile injection water wipes with non blood mucus. The results of bacterial monitoring and the incidence of nosocomial infection were compared before and after the intervention. Results There was no significant difference between two groups during the former four hours of the neurosurgery（P 〉 0.05）. Respectively after using microscope 5 h and 6 h, the qualified rate of bacteria monitoring on sterile protective sleeve surface were increased to 97/100（no wipe 71/100） and 95/100 （no wipe 51/100） in intervention group, the difference were statistically significant （X2=25.15, 49.11,P 〈 0.01）. Conclusions The bacteriostatic effect of cleaning blood stain on the surface of sterile protective during microscope operating is significant. The intervention is worthy of promotion in neurosurgery.