层流净化手术室术中感染因素分析及防控对策研究

肖明 侯毅芳 吴小华 周诩川

[摘要] 目的 探讨层流净化手术室术中感染因素及防控对策，降低医院感染发生率。方法 回顾性分析该院2016年5月—2018年4月于层流净化手术室中进行手术的患者7 800例为研究对象，男4 045例，女3 755例。年龄17～79岁，平均（52.7±11.7）岁。手术时间0.5～10 h，平均手术时间（3.4±1.3） h。该组患者中，择期手术者4 543例，急诊手术者3 257例。I类手术切口 4 324例，II类手术切口3 466例，Ⅲ类手术切口10例。 结果 7 800例患者中发生医院感染45例，感染发生率为0.58%。其中以手术切口部位感染居首，其次是呼吸道、泌尿系統、胃肠道和皮肤软组织等。患者年龄 、手术时间、手术模式、手术切口类型、合并症均可能是发生医院感染的危险因素（χ2=11.832、10.944、10.534、32.171、14.780，P<0.01）。结论 为降低层流净化手术室医院感染，要强化防控意识，规范手术操作规程，提高手术过程护理质量，才能取得较好的防控效果。

[关键词] 层流净化手术室;感染因素;预防

[中图分类号] R181.3+4          [文献标识码] A          [文章编号] 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.