不同手卫生方式对术后肺部感染的影响研究

目的 探讨全身麻醉过程中使用手消毒液及佩戴一次性薄膜手套对患者术后肺部感染发生率的影响.方法 选择气管插管全身麻醉手术(预计手术时间＞2 h)患者180例,按随机数字表法分为3组(每组60例):常规组(A组)、手消毒液组(B组)及薄膜手套组(C组).分别于麻醉前、麻醉2h及麻醉结束时对麻醉机吸气端、呼气端、储气囊口进行细菌采样,随后进行培养及鉴定.术后对患者进行5d随访,统计肺部感染发生率.结果 ①麻醉全程麻醉机通气系统中,A组污染标本共94份(52.22％),B组31份(17.22％),C组34份(18.89％).B组、C组麻醉全程麻醉机通气系统污染率低于A组(P＜0.05),B组、C组比较,差异无统计学意义(P＞0.05).②术后随访,A组患者中12例出现肺部感染,发生率为20.0％,B组、C组患者各出现2例肺部感染,发生率均为3.33％,B组、C组患者术后肺部感染发病率低于A组,差异有统计学意义(P＜0.05).结论 麻醉过程中使用手消毒液及佩戴一次性薄膜手套均可降低术中麻醉机通气系统污染率及患者术后肺部感染发生率.

The effect of different hand hygiene on postoperative pulmonary infection

Objective Studying the effect of different hand hygiene on the postoperative pulmonary infection between using hand-washing sterilization and using disposable plastic film gloves.Methods Totally 180 patients undergoing general intubation anesthesia were randomly divided into 3 groups:including normal group (group A),hand-washing sterilization group (group B) and using disposable plastic film gloves group (group C) (n=60).Samples were taken from the suction side,expiration side and store airbag of the anesthesia machine at the time points before the anesthesia,2 h after the anesthesia and the end of the anesthesia.Then these samples were used to do germiculture.Results ① The positive bacterial detection rates of the anesthesia machine ventilation system in group B (31/180,17.22％) and group C (34/180,18.89％) during the anesthesia are lower than that in group A(94/180,52.22％),but there was no difference between group B and group C (P＞0.05).② The postoperative pulmonary infection rates in B (2/60,3.33％) and C (2/60,3.33％) groups are lower than infection rates in group A (12/60,20％) (P＜0.05).Conclusions Hand hygiene by using hand-washing sterilization and using disposable plastic film gloves can decrease the occurrence rate of the bacterial detection in the anesthesia machine ventilation system and the postoperative pulmonary infection.