摘要
目的 分析手术相关人员手套破损的危险因素,为降低术中手套破损提供参考依据,进而提高手术安全性.方法 收集解放军总医院海南医院手术室2018年11-12月术中使用的手套,术后采用向手套内注水(1 000 ml)并加压的方法观察其是否破损,并记录破损的部位.比较分析不同类型手术、不同使用人员以及不同手术时长术中手套破损情况.结果 共收集不同手术各类人员术中使用手套1 608只,总破损率为11.9%(192/1 608).不同类型手术手套破损率分析发现,骨科手术手套破损率最高(20.5%),头颈面部手术(7.6%)和胸腹腔手术(8.3%)手套破损率均较低,三者比较差异具有统计学意义(x^ 2=51.510,P<0.001).手术医生使用的手套总数为1 203只,破损率为10.8%(130/1203),器械护士使用手套总数为405只,破损率为15.3%(62/405),除骨科躯干部手术外,器械护士手套破损率均明显高于手术医生(x^ 2=5.954,P=0.015).手术时长<60 min的手套总破损率最低(3.1%),超过60 min的手术手套破损率均超过10%,以151~180 min的手术手套总破损率最高(15.5%),不同类型手术手套破损率比较差异有统计学意义(x^2=28.197,P<0.001).手套破损的部位以指尖破损率最高,总破损率为10.6%(171/1608).佩戴双层手套的骨科手术中,内层手套破损率明显低于外层手套的破损率(2.3% vs 22.1%,x^2=31.351,P<0.001).结论 器械护士以及骨科医师尤其应注意术中手套破损情况,推荐术中常规佩戴双层手套.手术开始60 min以后推荐手术者与器械护士常规进行佩戴手套的完整性检查,如出现破损应及时更换手套,或者直接佩戴双层手套以降低术中整体手套破损率.
OBJECTIVE To investigate the risk factors for damage of gloves during surgery so as to prevent the damage of the gloves and improve the safety of surgery.METHODS The gloves that were used in operating rooms of Hainan Hospital of PLA General Hospital from Nov 2018 to Dec 2018 were collected and injected with 1000 ml of water and then were pressurized to observe whether the gloves were perforated,and the perforated parts were recorded.The rates of damage of gloves were compared among the different types of surgeries,glove users,and operation durations.RESULTS A total of 1608 gloves were collected from the personnel who used in different types of surgeries,and the total rate of damage was 11.9%(192/1608).The rate of damage of gloves was 20.5%(highest)in orthopedic surgery,7.6%in head,neck and face surgery,8.3%in thoracoabdominal surgery,and there was significant difference among the three(χ^2=51.510,P<0.001).Totally 1203 gloves were used by surgeons,and the damage rate was 0.8%(130/1203);totally 405 gloves were used by instrument nurses,and the damage rate was 15.3%(62/405);the damage rate of gloves of the instrument nurses was significantly higher than that of the surgeons except for the orthopedic trunk surgery(χ^2=5.954,P=0.015).The total damage rate of gloves was the lowest(3.1%)in the surgeries with duration less than 60 min,more than 10%in the surgeries with duration more than 60 min,the highest(15.5%)in the surgeries with duration ranging between 151 and 180 min,and there was significant difference in the damage rate of gloves among the different types of surgeries(χ^2=28.197,P<0.001).The damage rate of fingertip part of the gloves was the highest among the damaged gloves,with the total damage rate 10.6%(171/1608).Among the gloves that were worn in the orthopedic surgeries,the damage rate of the inner gloves was significantly lower than that of the outer gloves(2.3%vs 22.1%,χ^2=31.351,P<0.001).CONCLUSION The instrument nurses and orthopedics department doctors should pay attention to the damage of gloves,and double gloves are recommended to wear during the surgery.The integrity of the gloves of the surgeons and instrument nurses should be checked out after the surgery for 60 min,the gloves should be replaced in a timely manner once they are damaged,or double-layer gloves should be worn so as to reduce the damage rate of gloves.
作者
李雪
于秀荣
索继江
冯龙
吕丛
LI Xue;YU Xiu-rong;SUO Ji-jiang;FENG Long;LYU Cong(Hainan Hospital of PLA General Hospital,Sanya,Hainan 57000,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2020年第17期2701-2705,共5页
Chinese Journal of Nosocomiology
基金
三亚市医疗卫生科技创新基金资助项目(2018YW16、2018YW04) 。
关键词
医用无菌手套
手术
破损
危险因素
器械护士
Medical sterile gloves
Surgery
Damage
Risk factor
Instrument nurse
