摘要
目的评估综合干预措施对于控制老年人神经外科手术部位感染的效果。方法选择2012年6月至2014年5月我科行神经外科手术的老年患者1000例,以2013年6月开始实施综合干预措施为界,将进行手术的老年患者分为干预组和对照组,每组500例,对照组实施常规治疗,并进行回顾性调查分析,干预组进行前瞻性调查,通过进行目标性监测与综合干预、反馈和讨论,并提出改进方案,不断巩固和完善预防和控制老年神经外科手术患者手术部位感染的措施。结果经过综合干预后,干预组患者SSI的发生率为4.20%(21/500),对照组为7.40%(37/500),两组比较,差异具有统计学意义(P<0.05);其中,干预组表浅切口SSI的发生率为1.40%(7/500),对照组表浅切口SSI发生率为2.00%(10/500),两组比较,差异无统计学意义(P>0.05);干预组器官腔隙SSI的发生率为2.80%(14/500),对照组为5.40%(27/500),两组比较,差异具有统计学意义(P<0.05)。外科洗手正确率由干预前的48.28%提高至92.45%,切口感染的上报率由干预前的54.04%提高至85.71%,各项指标比较,差异均有统计学意义(P均<0.05)。切口异常的病原学送检率由干预前的53.23%提高至86.67%,经过比较,差异具有统计学意义(P<0.05)。结论经过综合干预能有效降低老年人神经外科手术部位感染的发生率,提高医护人员对手术部位感染的防控意识。
Objective To investigate the effect of comprehensive intervention in controlling surgical site infection of old patients who suffered neurosurgery. Methods Selected 1000 old patients who received neurosurgery in our hospital from June 2012 to May2014,divided the cases into experimental group and control group according to whether the comprehensive intervention conducted in June 2013,and there were 500 cases in each group,and the SSI in control group was retrospectively investigated,the cases in experimental group was prospectively investigated. Through the comprehensive intervention,feedback and discussion,the measures for prevention and control the surgical site infection were consolidated. Results In experimental group the incidence of SSI was 4. 20%（ 21 of 500 patients）,which was significantly lower than the control group（ 7. 4%,37 in 500cases; P 0. 05）,but the incidences of superficial SSI of experimental group and control group were 1. 40%（ 7 of500 patients） and 2. 00%（ 7 of 500 patients）,the difference was not statistically significant（ P 0. 05）. In experimental group,the incidence of organ space SSI was 2. 80%（ 14 of 500 patients）,which was significantly lower than the control group（ 5. 40%,27 /500; P 0. 05）. After intervention,the rate of correct surgical hand-washing was increased from 48. 28% to 92. 45%,timely reporting rate of SSI increased from 54. 04% to 85. 71%（ all P 0. 05）. And after intervention pathogen detection rate was significantly increased from 53. 23% to86. 67%（ P 0. 05）. Conclusions Comprehensive intervention could decrease the incidence of SSI in old patients who received neurosurgery,and improve the staffs ＇ awareness of surgical site infection prevention and control.
出处
《齐齐哈尔医学院学报》
2016年第9期1163-1165,共3页
Journal of Qiqihar Medical University
关键词
综合干预
神经外科
老年人
手术部位感染
Comprehensive intervention
Neurosurgery
Elderly people
Surgical site infection
