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目的探讨氯己定醇脱碘对手术部位皮肤微生态的改变情况,寻求一种既能达到良好的消毒效果又不影响手术部位皮肤菌群平衡的消毒方法。方法将需产科住院行会阴侧切手术的患者随机分为实验组和对照组,每组100人。实验组手术部位皮肤聚维酮碘原液消毒后,用氯己定醇进行脱碘;对照组常规聚维酮碘原液消毒。两组分别于消毒前、消毒后30 min、60 min作细菌学检测,观察不同消毒方法对手术部位皮肤细菌数的影响。结果消毒后30 min细菌消毒合格率实验组为100%,对照组为80%,两组差异有极显著性(P<0.01);消毒后60 min细菌消毒合格率实验组为90%,对照组为45%,两组差异有极显著性(P<0.01)。两组消毒前后分别进行皮肤细菌分型和菌种鉴定,均为常驻菌和暂住菌,未发现致病菌。结论氯己定醇脱碘可提高手术部位皮肤消毒细菌达标率,且不影响手术部位皮肤微生态平衡。
Objective To investigate the changes of skin micro-ecology of dexidated chlorhexidine alcohol in the surgical site and to find a way of disinfection that can achieve a good disinfection effect without affecting the balance of skin flora at the surgical site. Methods Patients in obstetrics and gynecology admitted to the hospital were randomly divided into experimental group and control group, with 100 in each group. The experimental group of skin povidone-iodine solution after disinfection, with chlorhexidine alcohol deiodination; conventional povidone iodine solution disinfection. Bacteriological tests were performed on the two groups before and 30 min and 60 min after disinfection to observe the effect of different disinfection methods on the number of bacteria in the skin of the surgical site. Results The pass rate of bacterial disinfection 30 min after disinfection was 100% in the experimental group and 80% in the control group, with significant difference between the two groups (P <0.01). The passing rate of bacteria in the experimental group after disinfection 60 min was 90% 45%, there was a significant difference between the two groups (P <0.01). Before and after disinfection of the two groups of skin bacterial typing and strain identification, are resident bacteria and temporary bacteria, no pathogenic bacteria found. Conclusion Dechlorination of chlorhexidine alcohol can improve the rate of skin disinfection bacteria in the surgical site, and does not affect the skin micro-ecological balance in the surgical site.