手术环境及手卫生对内镜下粘膜剥离术后患者肺部感染的影响

Impact of Operation Environment and Hand Hygiene on Pulmonary Infection after Endoscopic Submucosal Dissection

目的评价手术环境及手卫生对内镜下粘膜剥离(ESD)术后患者肺部感染的影响。方法选取200例需行胃部ESD术的患者,按照其手术操作环境分为诊疗室组108例、手术室组92例,选择80例胃镜下胃息肉氩离子凝固术的患者作为对照组。监测各组患者周围物表细菌菌落数、参加手术的医务人员手部的细菌菌落数。结果手术后立即检测患者周围物表细菌菌落数,手术室组(18.93±0.25 cfu/m^2)明显低于诊疗室组(40.23±0.71 cfu/m^2)及对照组(29.16±0.92 cfu/m^2),具有统计学差异(P<0.05);手术后立即检测医务人员手部细菌菌落数,手术室组(17.54±0.47 cfu/m^2)明显低于诊疗室组(38.05±0.81 cfu/m^2)及对照组(25.18±0.51 cfu/m^2),具有统计学差异(P<0.05);手术室组术后肺部感染发生率(3.26%)明显低于诊疗室组(7.41%),具有统计学差异(P<0.05)。结论手术室内具有合理的工作流程及严格的手卫生管理措施,这些措施能减少患者周围物表菌落数,降低ESD术后患者肺部感染的发生率。

Objective To evaluate the impact of operation environment and hand hygiene on pulmonary infection after endoscopic submucosal dissection(ESD).Methods 200 cases undergoing ESD were divided into 2 groups based on different operation environments:gastroscopy room group(108 cases)and operation room group(92 cases);80 cases undergoing endoscopic argon plasma coagulation to treat gastric polyp were enrolled in control group;the number of air bacteria around the cases and on the hands of medical staff were detected.Results The number of air bacteria around the cases in operation room group(18.93±0.25 cfu/m^2)was significantly lower than that in gastroscopy room group(40.23±0.71 cfu/m^2)and that in control group(29.16±0.92 cfu/m^2)(P<0.05);the number of air bacteria on the hands of hospital workers in operation room group(17.54±0.47 cfu/m^2)was significantly lower than that in gastroscopy room group(38.05±0.81 cfu/m^2)and that in control group(25.18±0.51 cfu/m^2),(P<0.05);the occurrence of pulmonary infection in operation room group(3.26%)was significantly lower than that in gastroscopy room group(7.41%),(P<0.05).Conclusions The rational workflow and strict hand hygiene administration in operation room are of help in reducing environmental bacterial count and post-ESD pulmonary infection occurrence.