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目的调查洁净手术室无菌台质量动态变化,探讨预防措施。方法共调查医院洁净手术间的百级1间,千级、万级各两间,每间手术室各观察5台手术;铺巾和剪刀采用表面涂抹法,棉球取1颗直接投入10ml无菌生理盐水中作微生物检测,采样时间分别为手术开始(0)、1、2、3、4h;结果判断以无细菌检出为合格,对不同样本的各时间段合格率进行统计比较。结果铺巾表面在2h保持无菌,3h后检测有细菌;剪刀和棉球则从4h开始检测到细菌,但合格率比较差异无统计学意义;25台手术中有3台6个检测点出现无菌台细菌不合格,均为1CFU/平皿,其中千级洁净间4h的棉球1次,5次发生在万级洁净间,分别是铺巾表面1、4h(万级1号间和万级2号间),剪刀、棉球4h各1次,但合格率比较差异无统计学意义;导致无菌台质量不合格的原因可能与手术时间的延长,手术过程中人流、物流较频繁及某些医务人员无菌操作观念不强、动作不规范有关。结论强化无菌手术意识,严格环境管理,严格人流、物流管理,严格无菌台的管理,是保证无菌台质量的有效措施。
Objective To investigate the dynamic changes of sterile table quality in clean operating room and to explore the preventive measures. Methods A total of one hundred, one thousand, one thousand and two hundred hospitals were surveyed in the clean operation room of the hospital. Five surgeries were observed in each operating room. The drapes and scissors were smeared on the surface with a cotton ball and put directly into 10ml Microorganisms were detected in the bacteria physiological saline. The sampling time was the beginning of the operation (0), 1,2,3,4 h respectively. The results were judged as bacteria free, and the pass rates of different samples were statistically compared. Results The surface of paved towel kept sterile for 2 hours and bacteria were detected after 3 hours. Scissors and cotton balls detected bacteria from 4 hours later, but there was no significant difference in passing rate. There were 3 sets of 6 testing points in 25 surgeries Sterile bacteria bacteria, are 1CFU / plate, of which one thousand 4s cotton balls clean 1 time, 5 times in the million clean room, respectively, the shop towel surface 1,4h Grade 2), scissors, cotton balls 4h each 1 times, but the pass rate was no significant difference between the results; resulting in failure of the quality of the sterile stage may be related to the extension of the operation time, the flow of people during the operation more frequent and logistics Some medical staff aseptic operating concept is not strong, the action is not standardized. Conclusion Strengthening the awareness of aseptic surgery, strict environmental management, strict flow of people, logistics management, strict aseptic station management, is to ensure the quality of sterile stage effective measures.