摘要
目的探讨综合干预措施预防经皮椎间孔镜术治疗腰椎间盘突出症围术期感染的效果,以降低围术期感染率,提高其治疗水平。方法选取2009年10月-2012年10月医院行经皮椎间孔镜技术治疗的腰椎间盘突出症患者124例,将其按照数字随机表法随机分为对照组和观察组,每组各62例,对照组采用常规治疗和干预,术前使用预防性抗菌药物,术后做好预防感染的管理,观察组在对照组常规预防感染的基础上,组成医院感染质量控制小组对患者围术期预防感染进行综合干预,比较两组患者围术期环境、器械、操作等方面预防医院感染检查结果及术后医院感染发生率。结果两组患者围术期医院感染质量控制指标比较,观察组患者在手术环境、病房环境、医疗器械、患者预防感染认知水平等较对照组均具有显著的优势,差异有统计学意义(P<0.05);对照组患者术后发生感染6例,感染率为9.7%,观察组仅出现1感染,感染率为1.6%,两组比较差异有统计学意义(P<0.05)。结论椎间隙感染为经皮椎间孔镜技术治疗腰椎间盘突出症的严重并发症,做好围术期综合干预措施,重点加强手术过程的无菌操作技术、手术室环境监控、手术器械无菌管理及术后精心护理,可有效降低术后切口和椎间隙感染发生率。
OBJECTIVE To study the effect of comprehensive intervention measures on prevention of nosocomial infections in patients with lumbar disc herniation during perioperative period of percutaneous transforaminal microscopy so as to reduce the infection rate and improve the treatment level. METHODS A total of 124 patients with lumbar disc herniation, who underwent the percutaneous transforaminal microscopy in the hospital from Oct 2009 to Oct 2012, were enrolled in the study and randomly divided into the control group and the observation group with 62 cases in each; the control group was treated with the conventional interventions, the prophylactic antibiotics were used before the surgery, and the infections were controlled after the surgery; while the observation group was treated with the comprehensive interventions performed by the infection control quality team on the basis of the conventional interventions of the control group; the effect on prevention of perioperative nosocomial in[ections related to the environment, instruments, and operations and the incidence of postoperative nosocomial infections were observed and compared between the two groups. RESULTS As compared with the indicators for quality control of nosocomial infections, the observation group showed more significant advantages in the surgical environment, ward environment, medical instruments, and patientsr cognition of prevention of infections than the control group, the differences were statistically significant （P~ 0. 05）. The postoperative infections occurred in 6 cases in the control group with the infection rate of 9. 7~ and only in 1 case in the observation group with the infection rate of 1. 6~, the difference between the two groups was statistically significant （P〈~0.05）. CONCLUSION The intervertebral infection is a severe complication of the lumbar discherniation patients undergoing the percutaneous transforaminal microseopy; it is an effective to implement the comprehensive intervention measures during the perioperative period, focus on the aseptic operation techniques during the surgical procedures, monitoring of operating room environment, and management of sterilized instruments, and conduct dedicated postoperative nursing so as to reduce the incidence of postoperative incision infections or interverteral infection.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2014年第4期944-946,共3页
Chinese Journal of Nosocomiology
基金
北京市卫生局规划基金项目(BW-2010B-012)
关键词
经皮椎间孔镜技术
腰椎间盘突出症
医院感染
预防研究
Percutaneous transforaminal microscopy
Lumbar disc herniation
Nosocomial infection
Prevention
