外科手术中术者手部细菌数量监测研究

目的对于外科手术术中外科医生的手部的细菌数量进行监控，从而为手术过程中手卫生的维持提供有效的指导依据。方法对2011年2月～2012年7月我院行40例（台）“关节置换手术”和“脊柱手术”患者的10名手术医生分别于手部消毒后1 h、2h、3 h监测手部细菌菌落的培养结果及比较不同学历、职称的外科医生的手部细菌菌落的培养结果。结果10名医生外科手消毒后1 h手部细菌菌落（1.3±0.4）cfu/cm2，消毒后2h手部细菌菌落（34±8.4）cfU/cm2，消毒后3 h手部细菌菌落（46±6.3）cfu/cm2。不同时间点外科医生手部细菌菌落培养结果之间有显著统计学差异（F=167.96，P〈 0.01）。与外科手消毒后1 h,外科医生手部菌落数相比2 h和3 h外科医生手部菌落数显著增多（P〈 0.01）。与2 h外科医生手部菌落数相比，外科手消毒后3 h时外科医生手部菌落数显著增多（P〈 0.01）。10名外科医生手部细菌菌落的培养结果与医生学历、职称无关，差异无显著性（P〉0.05）。结论手术时间越长，术者手部细菌数量越多，引起手术后感染的机会将会增加。通过此项研究，改变了医生观念，手术时间超过3 h除应用抗生素外能主动采取重新手消毒或术前戴双层手套的措施。

A study of the number of bacteria on the surgeon hand

Objective To monitor the number of bacteria on surgeon＇s hand in the surgical technique, and provideeffective ways to maintain asepsis. Methods From February 2011 to July 2012, choosing surgeon having joint replacement operation and spinal operation,the surgeon hand sample collected at different times of the operation,1 hour, 2hours,3 hours. Culture results of the comparison of different education,job title and the surgeon＇s hand bacterialcolonies. Results Ten doctors surgical hand disinfection 1 hours hand bacterial colonies（1.3 ± 0.4）cfu/cm2,2 hours after the hand disinfection bacterial colonies（34 ± 8.4）cfu/cm2,3 hours after the disinfection of hands bacterial colonies（46 ± 6.3） cfu/cm2. Statistically significant difference （F = 167.96,P 〈 0.01） between the different time points surgeonhand colonies of bacteria culture results. Hour after the surgical hand disinfection,the surgeon＇s hands the number ofcolonies compared to the 2h and 3h surgeon, hand the number of colonies was significantly increased （P 〈 0.01）. 2 hsurgeon hand the number of colonies of surgical hand disinfection 3h surgeon hand the number of colonies was significantly increased（P 〈 0.01）. Regardless of the 40 surgeons hand colonies of bacteria culture results with the doctor＇s education,job title,there was no significant difference （P 〉 0.05）. Conclusion The longer the surgery operation time,the more the number of bacteria will increase the chance of infection caused by surgery. Through this study,to changethe concept of surgeon, for the surgery is more than 3 hours, the surgeon should take the double gloves or re-disinfecthands In addition to the use of antibiotics.