【摘要】 目的探索分阶段氯己定消毒法对开颅手术患者头皮细菌的抑制效果。方法选择2017年10月至2019年2月我院神经外科择期开颅手术患者200例,将其随机分为试验组1、2及对照组1、2,各50例。对照组1术前12 h用普通洗发液洗头1次,试验组1在此基础上用2%葡萄糖酸氯己定消毒1次;对照组2于术前12、2 h用普通洗发液洗头2次,试验组2在此基础上用2%葡萄糖酸氯己定消毒2次。比较各组术中1、4 h细菌培养结果及术后颅内感染情况。结果术中1 h,四组患者术区细菌培养阳性率比较,差异无统计学意义(P>0.05)。术中4 h,试验组2细菌培养阳性率显著低于试验组1、对照组1、对照组2,差异均具有统计学意义(P<0.05)。术中1 h的细菌培养阳性率显著低于术中4 h(P<0.05)。四组患者术后颅内感染率比较,差异无统计学意义(P>0.05)。结论葡萄糖酸氯己定是一种安全有效的术前头皮消毒剂,在分阶段术前头皮消毒中可以抑制深部细菌向表面迁移,降低开颅手术术区头皮细菌培养阳性率。更多还原

【Abstract】 Objective To explore the inhibitory effect of phased chlorhexidine disinfection on scalp bacteria in patients undergoing craniotomy. Methods From October 2017 to February 2019, 200 patients undergoing selective craniotomy in neurosurgery department of our hospital were randomly divided into experimental group 1, 2 and control group 1, 2, with 50 cases in each group. The control group 1 was washed once with ordinary shampoo at 12 hours before operation, and the experimental group 1 was sterilized once with 2% chlorhexidine gluconate on this basis; the control group 2 was washed twice with ordinary shampoo at 12 and 2 hours before operation, and the experimental group 2 was sterilized twice with2% chlorhexidine gluconate on this basis. The results of bacterial culture at 1 and 4 hours after operation and intracranial infection in each group were compared. Results There was no significant difference among the four groups in the positive rates of bacterial culture in the operation area at 1 hour during the operation(P>0.05). At 4 hours during the operation, the positive rates of bacterial culture in the operation area in the experimental group 2 was significantly lower than that in the experimental group 1, the control group 1 and the control group 2, the differences were statistically significant(P<0.05).The positive rate of bacterial culture at 1 hour during the operation was significantly lower than that at 4 hours during the operation(P<0.05). There was no significant differences in the rates of postoperative intracranial infection among the four groups(P>0.05). Conclusion Chlorhexidine gluconate is a safe and effective disinfectant for the scalp before operation. It can inhibit the migration of deep bacteria to the surface in preoperative phased disinfection on scalp bacteria, and reduce the positive rate of bacterial culture in craniotomy.更多还原