杜贻豹韩晓东 张频 张弘玮 周玉龙 李昆 狄建忠（上海交通大学附属第六人民医院普外科 上海 200233）

不同外科洗手时间和方法对术前消毒效果的影响

杜贻豹*韩晓东 张频 张弘玮 周玉龙 李昆 狄建忠**
（上海交通大学附属第六人民医院普外科 上海 200233）

摘 要目的：比较不同外科洗手时间和方法对术前消毒效果的影响，探讨术前外科手消毒的最佳方法。方法：按完全随机的方法把手术医生和器械护士共100人平均分为4组：A组和C组分别揉搓洗手1 min 和3 min；B组和D组分别刷洗洗手1 min和3 min，以手细菌培养计数法比较消毒洗手前后手部菌落数、菌落阳性率及不同洗手时 间和方法对皮肤的影响。结果：各组外科消毒洗手前后菌落数及阳性率无明显差异（P＞0.05）；A、C 两组洗手后皮肤外观、完整性、感觉HSA评分较本组洗手前无明显变化（P＞0.05）；B、D 两组洗手后皮肤外观、完整性和感觉HSA评分较本组洗手前明显降低（P＜0.05）；四组洗手后皮肤湿度HSA评分较本组洗手前均明显增加（P＜0.05）。结论：洗手时间和方法对消毒效果无明显影响，揉搓法对皮肤损伤小，故临床上推荐1 min揉搓外科洗手法。

关键词外科洗手 消毒效果 医院感染

Effect of the different time and methods for surgical hand antisepsis on the efficacy of preoperative disinfection

DU Yibao*, HAN Xiaodong, ZHANG Pin, ZHANG Hongwei, ZHOU Yulong, LI Kun, DI Jianzhong**
(Department of General Surgery, The Sixth People’s Hospital Affiliated to Medical School, Shanghai Jiao Tong University, Shanghai 200233, China)

ABSTRACTObjective: To compare the effects of different time and methods for surgical hand antisepsis on the efficacy of preoperative disinfection and to investigate its best method. Methods: Total 100 surgeons and nurses were randomly divided into 4 groups based on the method for their surgical hand antisepsis: scrubbing hands for 1 min and 3 min in group A and C, and scrubbing hands with sponge for 1 min and 3 min in group B and D, respectively. The number and positive rate of colonies on hands were compared by colony counts before and after hand antisepsis and the effects of different time and methods on the skin were also investigated. Results: There were no significant differences in the number and positive rate of colonies before and after hand antisepsis among 4 groups (P>0.05). The appearance, intactness and sensation HAS score of the skin had no significant change after hand antisepsis compared with before antisepsis in group A and C (P>0.05), but significantly decreased in group B and D (P<0.05). The HAS score of moisture content was significantly increased after hand antisepsis compared with before antisepsis in all of four groups (P<0.05). Conclusion: The different time and methods for surgical hand antisepsis have no obvious influence on the disinfection effect, and 1 min scrubbing method has little lesion to skin. Therefore, it is clinically recommended as a method for surgical hand antisepsis.

KEY WORDShand antisepsis; disinfection effect; nosocomial infection

控制好医务人员手的卫生有利于降低医院感染率[1]。术前外科洗手作为一种简单易行的消毒措施，能有效预防和控制病原体传播，防止手术后感染的发生[2]。本研究通过不同外科洗手时间和方法的比较，增强手术人员对术前消毒洗手的重视，探索最佳术前洗手消毒方法，降低医院感染率。