层流净化手术室术中感染因素分析及防控对策研究

Analysis of Infection Factors and Prevention and Control Countermeasures in Laminar Purification Operation Room

目的探讨层流净化手术室术中感染因素及防控对策,降低医院感染发生率。方法回顾性分析该院2016年5月—2018年4月于层流净化手术室中进行手术的患者7800例为研究对象,男4045例,女3755例。年龄17~79岁,平均(52.7±11.7)岁。手术时间0.5~10 h,平均手术时间(3.4±1.3)h。该组患者中,择期手术者4543例,急诊手术者3257例。I类手术切口4324例,II类手术切口3466例,Ⅲ类手术切口10例。结果7800例患者中发生医院感染45例,感染发生率为0.58%。其中以手术切口部位感染居首,其次是呼吸道、泌尿系统、胃肠道和皮肤软组织等。患者年龄、手术时间、手术模式、手术切口类型、合并症均可能是发生医院感染的危险因素(χ^2=11.832、10.944、10.534、32.171、14.780,P<0.01)。结论为降低层流净化手术室医院感染,要强化防控意识,规范手术操作规程,提高手术过程护理质量,才能取得较好的防控效果。

Objective To investigate the infection factors and prevention and control measures during laminar flow purification operation room operation,and to reduce the incidence of nosocomial infection.Methods A retrospective analysis was performed on 7,800 patients who underwent surgery in the laminar flow purification operating room from May 2016 to April 2018 in the hospital,including 4045 males and 3755 females.The age ranged from 17 to 79 years,with an average of(52.7±11.7)years.The operation time was 0.5~10 h,and the average operation time was(3.4±1.3)h.Among this group of patients,4,543 were elective surgeries and 3257 were emergency surgeries.There were 4324 cases of type I surgical incisions,3466 cases of type II surgical incisions,and 10 cases of type III surgical incisions.Results 45 cases of nosocomial infection occurred in 7800 patients,the infection rate was 0.58%.Among them,infections at the surgical incision site ranked first,followed by the respiratory tract,urinary system,gastrointestinal tract,and skin and soft tissues.Patient age,operation time,surgical mode,type of surgical incision,and comorbidities may be risk factors for nosocomial infection(χ^2=11.832,10.944,10.534,32.171,14.780,P<0.01).Conclusion In order to reduce nosocomial infection in the laminar flow purification operating room,it is necessary to strengthen the awareness of prevention and control,standardize the operating procedures and improve the quality of nursing during the operation to achieve better prevention and control results.