口腔正畸科患者交叉感染影响因素分析及预防对策

Influencing factors for cross infection in orthodontics department patients and prevention countermeasure

目的研究分析口腔正畸科患者交叉感染影响因素及预防对策。方法选择2009年7月-2014年7月于医院口腔正畸科接受治疗且出现交叉感染的87例患者作为感染组,同时选择同期口腔科治疗未出现交叉感染的92例患者作为对照组,检测治疗中涉及的相关医疗器械表面的细菌数目,通过统计分析患者的一般资料及治疗中的影响因素,明确患者正畸治疗中出现交叉感染的危险因素,并提出针对性预防措施。结果医师口包使用后30min、2h及12h细菌平均数量分别为(1.1±0.3)CFU/cm2、(15.4±2.3)CFU/cm2、(71.4±4.1)CFU/cm2;多因素Logistic回归分析结果显示,患者合并糖尿病、治疗中未使用一次性器械、器械消毒及空气消毒差导致器械及空气污染、医师自我保护意识不强及治疗操作不规范均为引起口腔正畸科出现交叉感染的独立影响因素(P<0.05)。结论正畸治疗中出现交叉感染的影响因素较多,医务人员应做好感染的控制工作,提高自我保护意识及规范操作意识,严格做好空气及医疗器械的消毒工作,对可能出现交叉感染的环节重点监督,减少治疗后交叉感染问题的出现。

OBJECTIVE To explore the influencing factors for cross infection in orthodontics department patients and put forward the prevention countermeasures.METHODS Totally 87 patients who were treated in orthodontics department and had cross infection from Jul 2009 to Jul 2014 were chosen as the infection group,meanwhile,92 patients who were treated in the orthodontics department but did not have cross infection were set as the control group.The bacterial colony counts on surfaces of medical instruments involved in the treatment were detected,the baseline data of the patients and the influencing factors were statistically analyzed so as to define the risk factors for the cross infection during the orthodontic treatment and put forward the targeted prevention measures.RESULTS The average bacterial colony counts were respectively（1.1±0.3）CFU/cm2,（15.4±2.3）CFU/cm2 and（71.4±4.1）CFU/cm2 after the doctors used disposable toilet paper for 30 min,2 hours and 12 hours.The result of multivariate logistic regression analysis showed that the complication with diabetes mellitus,disposable instruments,instrument and air contamination due to poor disinfection of instrument and air,self-protection awareness of doctors and treatment procedures were the independent influencing factors for the cross infection in the orthodontics department patients（P〈0.05）.CONCLUSIONS There are a variety of influencing factors for the cross infection during the orthodontic treatment.It is necessary for the health care workers to control the infection,raise the self-protection and standard operation awareness,focus on the disinfection of air and medical instruments and strengthen the supervision of key links that are likely to have cross infection so as to reduce the incidence of the cross infection.