连台手术不同自净时间对Ⅲ级洁净手术室空气质量及手术部位感染的影响

doi:10.3969/j.issn.1671-7171.2025.11.007

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摘要 【目的】探讨连台手术不同自净时间对Ⅲ级洁净手术室空气质量及手术部位感染(surgical site infection, SSI)的影响。【方法】采用整群随机化设计,将12间Ⅲ级洁净手术室随机分为A组、B组、C组、D组,分别设定连台手术自净时间为5 min、10 min、15 min、20 min,每组最终纳入100例患者(100台手术)。于自净完成后即刻检测手术室中央区与周边区的细菌菌落总数及0.5 μm、5.0 μm尘埃粒子数,同时追踪患者术后30 d的SSI发生情况。【结果】A组周围区、中央区细菌菌落合格率分别为72.00%、77.00%,B~D组均为100.00%。A组周围区、中央区细菌菌落合格率与B组、C组、D组比较,差异有统计学意义(P<0.05),B组、C组、D组周围区、中央区细菌菌落合格率比较,差异无统计学意义(P>0.05)。A组、B组、C组、D组直径为0.5 μm尘埃粒子数分别为(1168.37±19.46)粒/m³、(500.97±12.40)粒/m³、(466.92±12.00)粒/m³、(445.78±12.44)粒/m³,A组与B组、C组、D组比较,差异有统计学意义(P<0.05);B组与C组比较,差异无统计学意义(P>0.05),B组与D组比较,差异有统计学意义(P<0.05);C组与D组比较,差异无统计学意义(P>0.05)。A组、B组、C组、D组直径为5 μm尘埃粒子数分别为(314.24±2.18)粒/m³、(166.60±2.39)粒/m³、(148.10±2.24)粒/m³、(137.92±2.33)粒/m³,各组比较,差异均有统计学意义(P<0.05)。四组SSI发生率比较,差异无统计学意义(P=0.245)。【结论】对于Ⅲ级洁净手术室,手术室医护人员数在10个以下,且手术切口为Ⅰ类、Ⅱ类的情况下,连台手术自净10 min 可有效改善手术室空气质量,且不会增加SSI的发生风险,有利于提高手术室的周转效率。

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关键词 ：手术室, 空气污染,室内, 外科伤口感染

Abstract：【Objective】To explore the effect of different air self-cleaning times between consecutive surgeries on air quality and surgical site infection (SSI) in Class Ⅲ clean operating rooms. 【Methods】A cluster randomized design was adopted. Twelve Class Ⅲ clean operating rooms were randomly divided into Groups A, B, C, and D, with the air self-cleaning time between consecutive surgeries set to 5 min, 10 min, 15 min, and 20 min, respectively. Finally, 100 patients (100 surgeries) were included in each group. Immediately after air self-cleaning, the total number of bacterial colonies and the number of 0.5 μm and 5.0 μm dust particles in the central and peripheral areas of the operating room were detected. Meanwhile, the occurrence of SSI within 30 days after surgery was tracked for all patients. 【Results】The qualification rates of bacterial colonies in the peripheral and central areas of Group A were 72.00% and 77.00%, respectively, while those of Groups B-D were all 100.00%. The qualification rates of bacterial colonies in the peripheral and central areas of Group A were significantly different from those of Groups B, C, and D (P<0.05), but there were no significant differences among Groups B, C, and D (P>0.05). The number of 0.5 μm dust particles in Groups A, B, C, and D was (1168.37±19.46) particles/m³, (500.97±12.40) particles/m³, (466.92±12.00) particles/m³, and (445.78±12.44) particles/³, respectively. Group A was significantly different from Groups B, C, and D (P<0.05); there was no significant difference between Group B and Group C (P>0.05), but there was a significant difference between Group B and Group D (P<0.05); no significant difference was found between Group C and Group D (P>0.05). The number of 5 μm dust particles in Groups A, B, C, and D was (314.24±2.18) particles/m³, (166.60±2.39) particles/m³, (148.10±2.24) particles/m³, and (137.92±2.33) particles/m³, respectively, with significant differences among all groups (P<0.05). There was no significant difference in the incidence of SSI among the four groups (P＝0.245). 【Conclusion】For Class Ⅲ clean operating rooms, when the number of medical staff is less than 10 and the surgical incisions are Class Ⅰ or Ⅱ, an air self-cleaning time of 10 min between consecutive surgeries can effectively improve the air quality of the operating room without increasing the risk of SSI, which is beneficial to improving the turnover efficiency of the operating room.

Key words： Operating Rooms Air Pollution, Indoor Surgical Wound Infection

收稿日期: 2025-09-23

中图分类号:

R124.33

基金资助:湖南省卫生健康委科研项目(编号:202204133084)

通讯作者: **E-mail:550892569@qq.com

引用本文:

张桂香, 贺聪, 刘爱华, 杨静, 张玲, 黄宇. 连台手术不同自净时间对Ⅲ级洁净手术室空气质量及手术部位感染的影响[J]. 医学临床研究, 2025, 42(11): 1864-1867.
ZHANG Guixiang, HE Cong, LIU Aihua, et al. Effect of Different Air Self-Cleaning Times between Consecutive Surgeries on Air Quality and Surgical Site Infection in Class Ⅲ Clean Operating Rooms. JOURNAL OF CLINICAL RESEARCH, 2025, 42(11): 1864-1867.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2025.11.007 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2025/V42/I11/1864

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