層流凈化手術室術中感染因素分析及防控對策研究

肖明 侯毅芳 吳小華 周詡川

[摘要] 目的 探討層流凈化手術室術中感染因素及防控對策，降低醫院感染發生率。方法 回顧性分析該院2016年5月—2018年4月于層流凈化手術室中進行手術的患者7 800例為研究對象，男4 045例，女3 755例。年齡17～79歲，平均（52.7±11.7）歲。手術時間0.5～10 h，平均手術時間（3.4±1.3） h。該組患者中，擇期手術者4 543例，急診手術者3 257例。I類手術切口 4 324例，II類手術切口3 466例，Ⅲ類手術切口10例。 結果 7 800例患者中發生醫院感染45例，感染發生率為0.58%。其中以手術切口部位感染居首，其次是呼吸道、泌尿系統、胃腸道和皮膚軟組織等。患者年齡 、手術時間、手術模式、手術切口類型、合并癥均可能是發生醫院感染的危險因素（χ2=11.832、10.944、10.534、32.171、14.780，P<0.01）。結論 為降低層流凈化手術室醫院感染，要強化防控意識，規范手術操作規程，提高手術過程護理質量，才能取得較好的防控效果。

[關鍵詞] 層流凈化手術室;感染因素;預防

[中圖分類號] R181.3+4? ? ? ? ? [文獻標識碼] A? ? ? ? ? [文章編號] 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.