对比氯已定和聚维酮碘预防手术伤口感染疗效的随机对照临床研究

发布时间：2018-04-19 13:54

本文选题：氯已定 + 聚维酮碘　；参考：《四川大学学报(医学版)》2017年03期

【摘要】：目的比较以氯已定和聚维酮碘为主要成分的两种消毒液进行外科消毒降低术后伤口感染率的效果。方法对2015年1月至2016年12月在四川大学华西医院施行清洁或可能受污染手术患者进行研究,将纳入的335例患者进行随机分组,试验组160例患者使用质量分数2%氯已定进行皮肤消毒,对照组175例患者使用质量分数5%聚维酮碘消毒,记录两组患者基本临床资料、术后30d内手术伤口感染率以及伤口感染部位情况并比较两组间的差异。结果共获得318例患者的完整随访数据,随访率为94.9%。其中试验组148例,对照组170例。两组患者年龄、性别、术前及术后抗生素使用情况、手术时间差异均无统计学意义(P0.05)。试验组术后总感染率低于对照组(5.4%vs.12.9%,P=0.03)。其中在浅表部位感染方面,试验组优势较明显(4.1%vs.10.6%,P=0.03),但深部感染率及器官周围感染率,两组间差异无统计学意义(P0.05)。两种消毒液总感染及浅表部位感染的差异在可能受污染的手术中有统计学意义(P0.05),而在清洁手术中无统计学意义(P0.05)。结论氯已定在预防可能受污染手术术后的总感染及浅表部位感染较聚维酮碘更有优势,但对于清洁手术,两种消毒液效果相当。
[Abstract]:Objective to compare the effect of surgical disinfection with chlorhexidine and povidone iodine as main components to reduce postoperative wound infection rate.Methods from January 2015 to December 2016, 335 patients undergoing cleaning or potentially contaminated surgery in Huaxi Hospital of Sichuan University were randomly divided into three groups.160 patients in the test group were disinfected with 2% chlorhexidine by mass fraction, 175 patients in the control group were disinfected with 5% povidone iodine by mass fraction. The basic clinical data of the two groups were recorded.The infection rate and site of wound infection within 30 days after operation were compared between the two groups.Results the complete follow-up data of 318 patients were obtained, and the follow-up rate was 94. 9%.There were 148 cases in the test group and 170 cases in the control group.There was no significant difference in age, sex, antibiotic use before and after operation and operation time between the two groups (P 0.05).The total infection rate in the experimental group was lower than that in the control group (5.4 vs 12.9B).In the superficial infection, the advantage of the test group was 4.1vs.10.6, but there was no significant difference between the two groups in the deep infection rate and the infection rate around the organs.The difference of total infection and superficial infection between the two kinds of disinfectant was statistically significant in the potentially contaminated operation (P 0.05), but not in the clean operation (P 0.05).Conclusion chlorine has more advantages in preventing total infection and superficial infection after operation than povidone iodine, but the efficacy of the two disinfectant solutions is the same for cleaning operation.
【作者单位】：四川大学华西医院麻醉手术中心;四川大学华西医院泌尿外科;
【分类号】：R614

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