术前洗必泰擦浴对降低椎管术后患者手术部位感染发生率的效果
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乔甫

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Evaluation of preoperative chlorhexidine bath for reducing the incidence of surgical site infection in patients undergoing spinal surgery
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    摘要:

    目的了解术前洗必泰擦浴对降低椎管术后手术部位感染(SSI)发生率的效果。方法对2013年1月—2014年12月某院神经外科行椎管手术且无植入物的所有患者进行监测,将所选病例分为对照组(2013年1—12月的患者,未采取干预措施)和实验组(2014年1—12月的所有监测患者,术前两晚采用1.8%~2.2%洗必泰进行擦浴),比较干预前后两组患者的SSI发生率,评价干预效果。结果共纳入椎管手术患者1 043例,发生SSI患者 41例,SSI发生率为3.93%,对照组和实验组SSI发生率分别为6.47%和2.34%,两组差异有统计学意义(P=0.001)。按对照组SSI发生率计算,实验组实际感染患者比预期感染患者少27例。SSI组患者平均住院费用为33 641.00元,非SSI组患者为23 072.50元,平均每例患者可节约住院费用10 568.50元。故通过采取干预措施共节约住院费用285 349.50元。减去实验组材料费费用2 100元,人力成本约12 820元,最终节约社会成本270 429.50元。对照组患者住院时间为10(8~12)d,实验组患者住院时间为9(8~12)d,经秩和检验,两者差异无统计学意义(Z=-0.68,P=0.50)。结论采取洗必泰擦浴进行干预,不仅可以降低手术部位感染发生率,还能节省住院费用,是否能缩短患者住院时间还需进一步研究的支持。

    Abstract:

    ObjectiveTo investigate the effect of preoperative chlorhexidine bath for reducing the incidence of surgical site infection(SSI) in patients undergoing spinal surgery.MethodsAll patients who undergoing spinal surgery (with no implants) in the department of neurosurgery of a hospital between January 2013 and December 2014  were monitored, the selected patients were divided into control group (JanuaryDecember of 2013, no intervention measures were taken) and trial group(JanuaryDecember of 2014, 1.8%-2.2% chlorhexidine bath for two nights before operation), incidence of  SSI between two groups of patients before and after intervention was compared, interventions effect was evaluated.ResultsA total of 1 043 patients undergoing spinal surgery were enrolled, 41(3.93%) had SSI, incidence of SSI  rates in control group and trial group were 6.47% and 2.34% respectively, the difference was statistically significant (P=0.001). According to the incidence of SSI in control group, actual infected patients in  trial group were 27 less than the anticipated patients with infection.The average hospitalization expense in SSI group and nonSSI group were ¥33 641.00 and ¥23 072.50 respectively,each patient could save  ¥10 568.50 on average. Therefore, through the intervention measures, ¥285 349.50 of hospitalization expense could be saved. Except ¥2 100 of trial material cost and ¥12 820 of manual labour cost, ¥270 429.50 of social cost was ultimately saved. The mean length of hospital stay in control group and trial group were 10 (8-12) days  and 9 (8-12) days respectively,rank test showed that the difference was not statistically significant(Z=-0.68,P=0.50).ConclusionChlorhexidine bath intervention can not only reduce SSI rate, but also save the expense of hospitalization, whether it can shorten the length of hospital stay needs to be further studied.

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李诗雨,黄文治,李莉,等.术前洗必泰擦浴对降低椎管术后患者手术部位感染发生率的效果[J]. 中国感染控制杂志,2016,15(8):583-586. DOI:10.3969/j. issn.1671-9638.2016.08.011.
LI Shiyu, HUANG Wenzhi, LI Li, et al. Evaluation of preoperative chlorhexidine bath for reducing the incidence of surgical site infection in patients undergoing spinal surgery[J]. Chin J Infect Control, 2016,15(8):583-586. DOI:10.3969/j. issn.1671-9638.2016.08.011.

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  • 收稿日期:2016-03-04
  • 最后修改日期:2016-05-12
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  • 在线发布日期: 2016-08-18
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