骨科手术铅衣消毒干预措施的研究

目的探讨针对骨科手术铅衣消毒采取的干预措施效果。方法调查某骨专科医院干预措施实施前后手术室铅衣清洁消毒效果和铅衣的使用情况,并对调查结果进行比较。结果干预前、干预三个月后以及干预半年后分别调查铅衣手术488、499、487例,铅衣使用次数分别为1 840、1 901、1 801次。干预前及干预三个月后,发现有可见血渍的铅衣百分率分别为12.55%和0.26%,差异有统计学意义(χ~2=238.99,P=0.00);干预实施半年后有可见血渍的铅衣百分率为0.11%,与干预三个月后相比无统计学差异(χ~2=1.13,P=0.29)。干预前及干预三个月后,铅衣表面菌落数合格率分别为72.34%和89.16%,差异有统计学意义(χ~2=171.24,P=0.00);干预实施半年后铅衣表面菌落数合格率为90.62%,与干预三个月后相比无统计学差异(χ~2=2.14,P=0.14)。干预前及干预三个月后,铅衣的重复使用率分别为19.29%和9.84%,差异有统计学意义(χ~2=70.08,P=0.00);干预实施半年后铅衣的重复使用率为6.22%,与干预三个月后相比差异有统计学意义(χ~2=16.31,P=0.00)。结论针对骨科手术铅衣消毒的干预措施能有效提高铅衣的清洁度,并且干预措施的持续效果较好。

Intervention measures for disinfection of lead clothes in orthopedic surgery

ObjectiveTo evaluate the effectiveness of intervention measures for disinfection of lead clothes in orthopedic surgery. MethodsCleaning and disinfection efficacy, as well as application of lead clothes in operating room in an orthopedic hospital before and after the implementation of intervention measures were investigated and compared. Results488, 499, and 487 pieces of lead clothes were investigated before, three months after, and six months after intervention, application of lead clothes were 1 840, 1 901, and 1 801 times respectively. Before and three months after intervention, 12.55% and 0.26% of lead clothes were found visible blood stains respectively, difference was statistically significant(χ2=238.99，P=0.00）；six months after the intervention, 0.11% of lead clothes were found to be stained with blood, there was no significant difference compared with three months after the intervention（χ2=1.13，P=0.29）. Before and three months after intervention, the qualified rates of bacterial colony on lead clothes were 72.34% and 89.16% respectively, difference was statistically significant（χ2=171.24，P=0.00）；six months after intervention，qualified rate of bacterial colony on lead clothes was 90.62%, difference was not statistically significant compared with three months after the intervention （χ2=2.14，P=0.14）. Before and three months after intervention, rate of repeated use of lead clothes were 19.29% and 9.84% respectively, diffe rence was statistically significant（χ2=70.08，P=0.00）；after six month intervention, rate of repeated use of lead clothes was 6.22%, which was significantly different from that after three month intervention（χ2=16.31，P=0.00）. ConclusionIntervention measures for lead clothes disinfection in department of orthopedic surgery can effectively improve the cleanliness of lead clothes, and the continuous effect of intervention measures is better.