層流凈化手術(shù)室術(shù)中感染因素分析及防控對(duì)策研究

肖明 侯毅芳 吳小華 周詡川

[摘要] 目的 探討層流凈化手術(shù)室術(shù)中感染因素及防控對(duì)策，降低醫(yī)院感染發(fā)生率。方法 回顧性分析該院2016年5月—2018年4月于層流凈化手術(shù)室中進(jìn)行手術(shù)的患者7 800例為研究對(duì)象，男4 045例，女3 755例。年齡17～79歲，平均（52.7±11.7）歲。手術(shù)時(shí)間0.5～10 h，平均手術(shù)時(shí)間（3.4±1.3） h。該組患者中，擇期手術(shù)者4 543例，急診手術(shù)者3 257例。I類手術(shù)切口 4 324例，II類手術(shù)切口3 466例，Ⅲ類手術(shù)切口10例。 結(jié)果 7 800例患者中發(fā)生醫(yī)院感染45例，感染發(fā)生率為0.58%。其中以手術(shù)切口部位感染居首，其次是呼吸道、泌尿系統(tǒng)、胃腸道和皮膚軟組織等。患者年齡 、手術(shù)時(shí)間、手術(shù)模式、手術(shù)切口類型、合并癥均可能是發(fā)生醫(yī)院感染的危險(xiǎn)因素（χ2=11.832、10.944、10.534、32.171、14.780，P<0.01）。結(jié)論 為降低層流凈化手術(shù)室醫(yī)院感染，要強(qiáng)化防控意識(shí)，規(guī)范手術(shù)操作規(guī)程，提高手術(shù)過程護(hù)理質(zhì)量，才能取得較好的防控效果。

[關(guān)鍵詞] 層流凈化手術(shù)室;感染因素;預(yù)防

[中圖分類號(hào)] R181.3+4? ? ? ? ? [文獻(xiàn)標(biāo)識(shí)碼] A? ? ? ? ? [文章編號(hào)] 1674-0742（2020）03（a）-0133-03

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

XIAO Ming， HOU Yi-fang， WU Xiao-hua， ZHOU Xu-chuan

Operating Room， Shenzhen Hospital， Peking University， Shenzhen， Guangdong Province， 518036 China

[Abstract] 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 4 045 males and 3 755 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 3 257 were emergency surgeries. There were 4 324 cases of type I surgical incisions， 3 466 cases of type II surgical incisions， and 10 cases of type III surgical incisions. Results 45 cases of nosocomial infection occurred in 7 800 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（χ2=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.