术中手套微穿孔及其相关因素分析

目的:调查和分析手术中手套微穿孔发生的相关因素及其防护。方法:收集7个科室手术用乳胶手套共390只,于术后采用水密封法检测微穿孔。将数据按术者角色、手术种类、手术持续时间及微穿孔部位等编码,进行二分类Logistic回归分析,检验微穿孔与有关因素的相关性。同一因素内两两比较用χ2检验。结果:微穿孔率为19.2%,微穿孔的发生与术者角色(Wals=19.475,P=0.000)、手术种类(Wals=29.132,P=0.000)、手术持续时间(Wals=8.858,P=0.014)、手套层数(Wals=7.234,P=0.007)和器械传递方式(Wals=6.791,P=0.009)相关性具有统计学意义。其中骨科与整形外科手术,术者与器械护士的手套微穿孔发生率高;手术持续时间越长,微穿孔发生率越高;右手穿孔占61.3%,左手穿孔占38.7%;拇指占28.0%,食指占42.7%,中指占13.3%,环指占2.7%,小指占1.3%,手掌占12.0%。双层手套及器械盘传递方式微穿孔发生率明显降低。结论:术中手套微穿孔发生与手术种类、术中角色和手术持续时间相关。采用器械盘传递器械,戴双层手套;缩短手术时间或在手术中更换手套,有利于降低手套微穿孔的发生率,对保护手套的完整性,防止双向感染具有重要意义。

Incidence and correlative factors of microperforation of surgical gloves

Objective：To investigate and analyze the incidence and correlative factors of microperforation of surgical gloves.Methods：Totally 390 surgical gloves were collected after operations and detected for microperforation with watertight test.Results：The microperforation rate was 19.2%.The incidence of microperforation was significantly related to the role of the operator,type of surgery,length of operative procedure.The rate of microperforation was higher in orthopaedics and orthopaedic surgery,also in the primary surgeon and scrub nurse.The rate of microperforation was 61.3% in right hand,38.7% in left hand,28.0% in thumb,42.7% in index finger,13.3% in middle finger and 12.0% in palm.But it was lower in double gloving and instrument-deliver with tray.Conclusion：The incidence of microperforation was significantly related to the role of the operator,type of surgery,length of operative procedure.Double gloving,delivering instrument with tray and shortening the operation time may reduce the incidence of microperforation.