不同消毒方法对静脉采血皮肤消毒效果的比较

摘要

Objective To compare the effects of different disinfection methods on skin disinfection effects in blood sampling,and to find a rapidly applicable method which is easy to operate and suitable for sampling of bloodculture.Methods We randomly sampled 303 patients in a 3A Grade Hospital from February 2016 to May 2016,and chose three parts,the fossa of left and right elbow and the cubitus of right arm,from every patient. Then those patients were divided into three groups according to skin disinfection methods used before blood sampling. The first group underwent the disinfection method of blood sampling stipulated by America Clinical Laboratory Standards Institute(CLSI);the second group was applied on Anerdian clockwise for one time;the third group was applied on Anerdian both clockwise and counter-clockwise each once. A skin swab on the same spot of every group was conducted before and after the disinfection for bacterial culture and colony counting,which was statistically analyzed by χ2 test.Results The difference of positive rate was statistically significant among three disinfection methods before and after disinfection(P1<0.01;P2<0.01;P3<0.01). No statistical significance was found in the difference between CLSI disinfection and both clockwise and counter-clockwise each once of Anerdian disinfection(P>0.05);statistical significance was found in the difference between CLSI disinfection and clockwise Anerdian disinfection once for each time(P<0.01);and there was statistical significance in the difference between both clockwise and counter-clockwise and clockwise Anerdian disinfection once for each time(P<0.01).Conclusions The effect of clockwise and counter-clockwise Anerdian disinfection once for each time is equivalent to that of the CLSI disinfection method for blood culture and sampling. Anerdian can be applied on skin disinfection for blood culture specimen via venous sampling,and it is more easy,rapid and economic to operate.%目的 比较不同消毒方法对静脉采血皮肤消毒的效果,找到一种操作简便、 快速适用的方法,适于采集血培养标本.方法 随机抽取某三甲医院2016年2月到5月的住院患者303例,每例患者取左、 右手肘窝及右手前臂3个部位,按照采血前使用不同的皮肤消毒方法分为3组.第1组是美国临床实验室标准协会(clini-cal laboratory standards institute,CLSI)规定的血培养采集消毒方法,第2组是安尔碘顺时针消毒1次,第3组是安尔碘顺逆时针各消毒1次.各组在消毒前、 后的同一部位各取1次皮肤拭子,进行细菌培养及菌落计数,用χ2检验进行统计分析.结果 3种消毒方法在消毒前后的细菌阳性率差异有统计学意义(P<0.01).CLSI的血培养采集消毒与安尔碘顺逆时针各1次消毒,差异无统计学意义(P>0.05);CLSI的血培养采集消毒与安尔碘顺时针1次消毒,差异有统计学意义(P<0.01);安尔碘顺逆时针各1次消毒与安尔碘顺时针1次消毒,差异有统计学意义(P<0.01).结论 安尔碘顺逆时针各消毒1次消毒效果与CLSI的血培养采集消毒等效,可运用于经静脉采集血培养标本的皮肤消毒,并比其简单、 快速、 经济适用.