急诊手术无菌灯柄细菌污染及影响因素分析

Analysis of Bacterial Contamination of Aseptic Lamp Handle and Influencing Factors in Emergency Surgery

目的明确急诊手术无菌灯柄不同时间点细菌污染情况及影响因素。方法选取某医院层流手术室进行的238台急诊手术使用的238个无菌手术灯柄为研究对象,重点对急诊手术在不同时间点的细菌污染情况及影响因素进行分析。结果在层流手术室使用的238个急诊手术的无菌灯柄中,有70个检出细菌(29.41%),单因素及多因素Logistic回归分析结果提示,存在血液污染及手术室人数≥10人等是导致急诊手术无菌灯柄细菌污染的危险因素(OR>1,p<0.05)。在238个急诊手术的无菌灯柄中,在手术后3小时开始有细菌检出,70个检出细菌的急诊手术无菌灯柄共分离培养出86株细菌。结论在层流手术室进行的急诊手术,无菌灯柄细菌污染情况与术中是否被血液污染及手术室人员数量等有关,相关细菌以革兰阳性菌为主,建议在急诊手术进行2小时内更换一次无菌灯柄。

Objective To investigate the bacterial contamination of aseptic lamp handle in emergency operation at different time points and its influencing factors.Methods A total of 238 aseptic lamp handles of 238 emergency operations in laminar flow operating room of a hospital were selected as the research objects.The bacterial contamination and related influencing factors of emergency operations in laminar flow operating room at different time points were analyzed.Results Bacteria were detected in 70 of 238(29.41%)aseptic lamp handles in laminar flow operating room.Univariate and multivariate logistic regression analysis showed that blood contamination and≥10 people in the operating room were the risk factors for bacterial contamination of aseptic lamp handle in emergency operations(OR>1,p<0.05).The bacteria started to be detected at 3 hours after operation.A total of 86 strains of bacteria were isolated from the 70 aseptic lamp handles with bacterial contamination.Conclusion For emergency operation in laminar flow operating room,the bacterial contamination of aseptic lamp handle is related to the existence of blood contamination during the operation and the number of personnel in the operating room.Gram-positive bacteria are the main bacteria.It is better to replace the aseptic lamp handle every 2 hours in emergency operations.