目的：了解抗菌手术薄膜对降低神经外科患者手术部位感染（SSI）的效果。方法将2012年1—12月某院神经外科病变手术患者分为使用抗菌手术薄膜组（A 组）和普通手术薄膜组（B 组），比较两组患者术后SSI 发生率，并进行危险因素分析。结果A 组患者术中手术切口薄膜起边率为38．3％（98／256），低于 B 组的96．88％（248／256），两组患者薄膜起边率比较，差异有统计学意义（χ2＝200．57，P ＜0．01）。512例患者，发生 SSI 17例，发生率为3．32％，A 组患者 SSI 发生率为1．56％（4／256），低于 B 组的5．08％（13／256）（χ2＝7．93，P ＜0．05）。神经外科 SSI 高危因素多因素分析结果表明，体重指数（BMI）≥24、出现围手术期低体温、吸烟、术前住院日数≥5 d，以及未使用抗菌手术薄膜均是神经外科 SSI 独立危险因素。结论神经外科手术中是否使用抗菌手术薄膜是神经外科 SSI 的独立危险因素之一；使用抗菌手术薄膜能有效降低起边率和 SSI 发生率，建议在神经外科手术中使用。%Objective To investigate the effect of antimicrobial-impregnated incise drape on preventing surgical site in-fection(SSI)following neurosurgical operation.Methods Patients undergoing neurosurgical operation from January to De-cember 2012 were divided into two groups:antimicrobial-impregnated incise drape group(group A)and general incise drape group(group B).The occurrence of SSI and risk factors for SSI were analyzed.Results Percentage of drape lifting at the wound edge in group A was lower than group B(38.3%[98/256]vs 96.88% [248/256],χ2 =200.57,P <0.01).Among 512 patients,SSI rate was 3.32%(n=17),SSI rate in group A was lower than group B(1.56%[4/256]vs 5.08%[13/256],χ2 = 7.93,P <0.05 ).Multivariate analysis revealed that body mass index ≥24,perioperative hypothermia,smok-ing,perioperative length of hospital stay ≥5 days,and lack of drape use were independent risk factors for SSI following neurosurgical operation.Conclusion Whether antimicrobial-impregnated incise drape is used in neurosurgical operation is one of the independent risk factors for SSI following neurosurgical operation,it can effectively reduce the drape lifting rate and incidence of SSI,and is recommended to be used in neurosurgical operation.
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