【摘要】 目的探讨2%葡萄糖氯己定(2%CHG)皮肤消毒液沐浴在骨科无菌手术前运用的可行性,有效预防与降低术后切口感染率。方法以160例骨科择期手术患者按术前两晚+术日晨、术前一晚+术日晨、术日晨2%CHG沐浴和改良骨科备皮法随机均分为试验组A、试验组B、试验组C和对照组,分别于各组患者首次备皮前、手术消毒前及术后24h对手术野皮肤采样,进行细菌检测并比较各组间差异。结果手术消毒前细菌培养与基线(首次备皮前)比较,试验组A、试验组B与对照组的细菌清除率分别为99.0%、98.9%97.9%,差异无统计学意义,试验组C细菌的清除率为95.8%,低于对照组,差异有统计学意义(P<0.05);术后24h手术野皮肤细菌培养,细菌菌落数试验组A为(3.90±1.80)CFU/cm2,对照组为(6.57±1.04)CFU/cm2,两组差异有统计学意义(P<0.05),其余各组与对照组相比菌落数均值差异无统计学意义,各组患者术后均无切口感染发生。结论术前两晚+术日晨2%CHG消毒液沐浴法在提高患者满意度、降低耗材和术后24h手术野菌落数培养等均优于改良骨科备皮法;术前备皮效果同于改良骨科备皮法,具有较大的临床价值。更多还原

【Abstract】 OBJECTIVE To explore the feasibility of application of 2% glucose chlorhexidine(2% CHG) skin disinfectant bath before the aseptic orthopaedic surgery so as to effectively reduce the incidence rate of surgical site infections.METHODS A total of 160 patients who underwent aseptic orthopaedic surgery were randomly divided into four groups according to the different disinfection methods: group A(2%CHG preoperative bathing 2 days before the operation and in the morning of operation day),the group B(2%CHG preoperative bathing 1 day before operation and in the morning of operation day),the group C(2%CHG preoperative bathing in the morning of operation day),and the control group(improved traditional orthopedic shaving method).Sterile cotton swab on operation wild skin samples were collected from each group before the skin preparation,before disinfection and 24 hours postoperation,respectively.And the data of bacterial detection was analyzed to compare the differences between the four groups.RESULTS There was no significant difference in the bacterial clearance rate among the group A(99.0%),group B(98.9%) and the control group(97.9%).The bacterial clearance rate of the group C was 95.8%,significantly lower than the control group,the difference was statistically significant(P<0.05).For the bacterial culture of samples from operation skin 24 hours after operation,the colony counts of the group A was(3.90±1.80) CFU/cm2,the control group(6.57±1.04) CFU/cm2,the difference was statistically significant(P< 0.05),and there was no statistical difference in the bacterial colony count between the other groups and the control group.The surgical incision infections did not occur in any of the groups.CONCLUSION 2%CHGpreoperative bathing 2 days before operation and in the morning of operation day is superior to the modified skin preparation method in improving the patients′satisfaction,reducing the consumables,and the culture of the wild bacterial colony 24 hours after the surgery.The effect of the preoperative skin preparation is similar to the modified orthopaedic skin preparation method,which has significant clinical value.更多还原