基于骨科防喷溅可视保护罩的关节置换手术中感染预防效果评价

Effect of orthopedic anti-splash visual shield on prevention of infection in joint replacement surgery

目的探讨防喷溅可视保护罩在关节置换手术感染控制中的应用效果,为提高手术室感染控制质量提供参考依据。方法选取2018年7月-2019年6月在吉林大学中日联谊医院行关节置换手术患者850例作为研究对象,采用随机数字表法将其分为试验组与对照组两组,每组425例。两组患者在手术室管理、供应室管理、病房管理和手术团队管理等方面均相同,试验组将防喷溅可视保护罩装置应用于关节置换手术中,对照组则未使用防喷溅可视保护罩装置,比较两组感染控制效果(不同时间段手术室内细菌数、术后假体周围感染发生率、物体表面监测合格率和物品灭菌合格率)和患者满意度。结果手术开始后60 min(28.13±1.96 CFU/m^(3)vs.269.52±8.57 CFU/m^(3))和手术结束时(36.45±7.52 CFU/m^(3)vs.284.35±11.72 CFU/m^(3))试验组室内细菌数均低于对照组(P<0.05)。试验组术后未见假体周围感染发生,对照组术后出现假体周围感染6例,感染率为1.41%。试验组术后假体周围感染发生率低于对照组(χ^(2)=4.196,P=0.041)。试验组患者对手术治疗的满意度(409例,占96.24%)高于对照组(390例,占91.76%)(P<0.05)。结论在关节置换手术中采用防喷溅可视保护罩可有效改善手术室空气质量,预防术后假体周围感染发生,提高物表监测合格率、物品灭菌合格率乃至患者满意度,提升手术室护理质量,值得临床借鉴。

OBJECTIVE To investigate the application effect of anti-splash visual protective cover in infection control of joint replacement surgery,and to provide reference for improving the quality of infection control in the operating room.METHODS A total of 850 patients who underwent joint replacement surgery in China-japan Friendship Hospital of Jilin University from Jul 2018 to Jun 2019 were recruited as the research subjects.They were divided into the experimental group and control group by using random number table method,with 425 patients in each group.The two groups of patients were under the same management of operating room,supply room,ward management and surgical team,except the application of the anti-splash visual protective cover device in the experimental group but not in the control group.The effect of infection control(the number of bacteria in the operating room at different times,the incidence of postoperative periprosthetic infection and the qualified rate of product culture)and patient satisfaction were compared between the two groups.RESULTS The number of bacteria in the experimental group was significantly lower than that in the control group 60 minutes after the operation(28.13±1.96 CFU/m^(3) vs.269.52±8.57 CFU/m^(3))and at the end of the operation(36.45±7.52 CFU/m^(3) vs.284.35±11.72 CFU/m^(3))(P<0.05).No peri-prosthesis infection was observed in the experimental group after operation,while 6 cases of peri-prosthesis infection occurred in the control group,with the infection rate of 1.41%.The incidence of periprosthetic infection in the experimental group was significantly lower than that in the control group(χ^(2)=4.196,P=0.041).The satisfaction in the experimental group(409 cases,96.24%)was significantly higher than that in the control group(390 cases,91.76%)(P<0.05).CONCLUSION The use of anti-splash visual protective cover in joint replacement surgery can effectively improve the air quality in the operating room,prevent postoperative infection around the prosthesis and improve the qualified rate of objects′surface and sterilization,improving patients′satisfaction and the quality of nursing in the operating room,which is worth of clinical reference.