儿童手术源性感染相关因素的临床研究

Clinical study on correlative factors of surgery caused infections in pediatric surgery

目的探讨儿童手术源性感染的相关影响因素,减少手术部位感染。方法选取该院的120台次手术,对手术室内动态空气菌落数、手术器械表面菌落数进行动态监测,并对空气中和手术器械表面菌落进行菌种分析。结果百级、千级、万级手术室动态空气菌落数均呈"N"字形分布;手术开始后1h,百级手术室空气菌落数变化量大于千级和万级手术室空气菌落数(P<0.05)。用无菌巾覆盖手术器械表面菌落增长速度显著慢于直接暴露在空气中的手术器械表面菌落(P<0.05);1%聚维酮碘擦拭后手术器械表面菌落增长速率显著慢于未擦拭血渍和生理盐水擦拭血渍的手术器械表面菌落(P<0.05);手术室空气中菌种和手术器械表面菌种分布一致。结论儿童手术源性感染与手术室内空气菌落数、手术器械表面菌落数、手术时间呈显著相关性。

Objective To＇analyze the factors related to surgical caused infections in children for reducing the infection of operative site. Methods A total of 120 case-times of operation in this hospital were selected. The dynamical air colony number and colony number of surgical instruments were performed the dynamic monitoring. The bacterial colony in air and surface of operative instruments were performed the bacterial species analysis. Results The dynamical air colony number in class 100, 1 000,10 000 operating room all presented as ＂N＂ character pattern distributionat 1 h after operation beginning, the variation of air colony number in class 100 operating room was significantly higher than that in class 1 000 and 10 000 operating rooms（P〈0.05）. The surface colony increase rate of sterile towel wrapped sterile operating instruments was significantly slower than that of the operating instruments directly exposing to air（P〈0, 05）. The surface colony increase rate Of operating instruments scrubbed by 1% povidone-iodine was significantly slower than that of operating instruments without scrubbing bloodstain and with scrubbing bloodstain by normal saline（P〈0.05）. The bacterial species distribution in operating room air was consistent with that in operating instrument surface. Conclusion The operation caused infection in children is significantly correlated with the operating room bacterial colony number and operation time.