手术室导致骨科无菌切口手术感染的影响因素及护理干预

Influencing Factors and Nursing Intervention of Surgical Operation Leading to Orthopedic Sterile Incision

目的分析手术室导致骨科无菌切口手术感染的影响因素和护理干预措施,为临床护理提供参考。方法回顾性分析该院2017年骨科无菌切口手术患者180例(对照组)手术感染影响因素,实施相对应的护理干预措施,分析2018年骨科无菌切口手术患者220例(干预组)护理干预实施效果。结果患者急诊切口感染发生率(27.6%)显著高于平诊(17.3%),差异有统计学意义(P<0.05),层流手术室患者切口感染发生率(21.6%)显著低于非层流室(14.6%),差异有统计学意义(P<0.05)。有参观人员患者感染发生率(22.5%)显著高于无参观人员(6.9%),差异有统计学意义(P<0.05)。腰髋部以下感染发生率(22.0%)显著高于颈肩上肢(16.1%),差异有统计学意义(P<0.05),手术时间>3 h患者切口感染发生率(23.1%)显著高于手术时间<3 h患者(18.3%),差异有统计学意义(P<0.05)。骨科无菌手术切口感染手术室相关因素主要包括手术类型、手术地点、参观人员、手术部位、接台手术、手术时间,差异有统计学意义(P<0.05)。护理干预实施前,对照组患者手术室切口感染36例,感染率为20.0%,护理干预实施后,干预组患者手术切口感染19例,感染率为8.6%,干预组患者切口感染率显著低于对照组,差异有统计学意义(χ^2=13.34,P<0.05)。干预组患者生活功能评分(89.6±2.9)分和生活质量评分(92.3±8.6)分均显著高于对照组(79.3±8.5)分、(77.5±8.4)分,差异有统计学意义(t=4.82、5.91,P<0.05)。结论手术室导致骨科无菌切口手术感染影响因素包括手术类型、参观人员、手术部位等,采用相应护理干预措施能够降低切口感染发生率,具有推广价值。

Objective To analyze the influencing factors and nursing interventions for surgical infection of aseptic incision in operating room,and provide reference for clinical nursing.Methods A retrospective analysis of the factors affecting surgical infection in 180 patients(control group)of aseptic incision surgery in our hospital in 2017,and the implementation of corresponding nursing intervention measures,analysis of 220 patients(intervention group)nursing intervention in 2018 orthopedic sterile incision surgery implementation effect.Results The incidence of emergency incision infection(27.6%)was significantly higher than that of the normal diagnosis(17.3%),the difference was statistically significant(P<0.05).The incidence of incision infection in the laminar flow operating room(21.6%)was significantly lower than that in the non-laminar flow chamber(14.6%),the difference was statistically significant(P<0.05).The incidence of infection among visitors(22.5%)was significantly higher than that of non-visitors(6.9%),the difference was statistically significant(P<0.05).The incidence of infection below the waist and hip(22.0%)was significantly higher than that of the upper and lower neck(16.1%),the difference was statistically significant(P<0.05).The incidence of incision infection(23.1%)in patients with operation time greater than 3 h was significantly higher than that in patients with operation time less than 3 h(18.3%),the difference was statistically significant(P<0.05).The related factors of orthopedic sterile incision infection in the operating room mainly include the type of operation,the location of the operation,the visitor,the surgical site,the operation of the station,and the operation time,the difference was statistically significant(P<0.05).Before the implementation of nursing intervention,36 cases of operation incision infection in the control group,the infection rate was 20.0%.After the implementation of nursing intervention,19 cases of surgical incision infection in the intervention group,the infection rate was 8.6%,and the infection rate of the intervention group was significantly lower than that of the intervention group.Control group,the difference was statistically significant(χ^2=13.34,P<0.05).The life function scores(89.6±2.9)points and quality of life scores(92.3±8.6)points in the intervention group were significantly higher than those in the control group(79.3±8.5)points and(77.5±8.4)points,the difference was statistically significant(t=4.82,5.91,P<0.05).Conclusion The factors affecting the surgical infection of orthopedic sterile incision in the operating room include the type of surgery,visitors,and surgical site.The corresponding nursing interventions can reduce the incidence of wound infection and have a promotion value.