手部卫生与医院感染的研究进展

Progress of research on hand hygiene and hospital infection

医疗机构中医务人员手上携带的细菌已成为医院感染的主要致病源,这些病原体不仅可从已感染伤口或引流伤口处获得,还可从正常、完整的皮肤区域获得。手的清洗和消毒是防止医院感染的最重要措施之一。论文概述了手清洗、卫生手消毒和外科手消毒的分类定义。并对目前使用的酒精、洗必泰葡萄糖酸盐、碘伏、六氯酚、三氯生等各类手卫生产品的作用机理、效果对比及其特点进行了讨论。总结了手卫生存在的一些问题,包括医护人员手卫生遵守率低下,医疗机构对手卫生的重视不足,细菌对消毒剂敏感度的降低和消毒剂使用中发生的接触性皮炎等。并就如何降低接触性皮炎的发生率、减少杀菌剂不利效果的方法、提高手卫生遵守率等一些最新的旨在改进手卫生状况的策略和对策进行阐述。

The germs on the hands of medical personnel in medical institutions have become the chief pathogens for hospital infection. These pathogens can be acquired not only from infected wounds or drainage wounds but also from normal and whole skin regions. Hand washing and disinfection is one of the most important measures for preventing hospital infection. The paper describes the definitions of hand washing, hygienic hand disinfection and surgical hand disinfection and discusses the action mechanisms, effects and features of various hand hygiene products currently in use, such as alcohol, hibitane glucose saline and hexachlorophenol. It enumerates a number of problems inhand hygiene, including low rate of hand hygiene observance on the part of medical personel, insufficient attention to hand hygiene on the part of medical institutions, reduction of germs' sensitivity to disinfectants, and the occurrence of contact dermatitis in disinfectant usage. The paper also gives an account of some of the latest strategies and countermeasures aiming at improving the status of hand hygiene, These include ways of lowering the incidence of contact dermatitis, reducing the bad effects of germicides, and raising the rate of hand hygiene observance.