鼻前庭病原菌去定植对减少院内呼吸道感染的影响

顾建丽 李林 陶臻

【摘要】目的：探索有效合理的消毒方法及操作程序，并将其应用于高危科室，通过实际的应用研究来探讨鼻前庭清洗对于减少院内呼吸道感染发生的作用，进而为制定减少院内呼吸道感染发生的措施提供参考。方法：从南京医科大学附属南京医院的高危科室中随机抽取90名医护人员纳入研究。针对受试者，在6个月后观察被采样医务人员的头痛、咳嗽和乏力等感冒症状以及发热情况和院内呼吸道感染发生率。分别测试受试者在应用碘伏和生理盐水清洗鼻前庭4 h 的情况，研究碘伏清洗鼻前庭在减少院内呼吸道感染方面的有效性。结果：在随机选取的90例受试者中，应用碘伏清洗鼻前庭后，在6个月后观察被采样医务人员的头痛、咳嗽和乏力等感冒症状以及发热情况相比于 B、C 组的水平降低，降低水平略为显著。在6个月后观察比较的院内呼吸道感染发生率，碘伏清洗鼻前庭会让院内呼吸道感染率相比于 B、C 组的水平降低，降低水平略为显著（P <0.05）。结论：应用碘伏清洗鼻前庭可有效减少发热、感冒的人数，表明该方法为制定减少院内呼吸道感染的措施提供参考。

【关键词】碘伏;鼻部定植;感染控制

【中图分类号】R765.1 R198.38【文献标识码】A 【文章编号】2096-5249（2021）22-0010-03

Effect of decolonization of nasal vestibular pathogens on reducing nosocomial respiratory tract infections

Gu Jian-li 1， Li Lin 2， Tao Zhen 3

1.Department of General Medicine， Nanjing Hospital A?liated to Nanjing Medical University， Nanjing 210029， China

2.Physical Examination Center， Nanjing Hospital A?liated to Nanjing Medical University， Nanjing 210029， China

3.Department ofInfectious Diseases， Nanjing Hospital A?liated to Nanjing Medical University， Nanjing 210029， China

【Abstract】Objective：Explore e?ective and reasonable disinfection methods and operating procedures，and apply them to high-risk departments.Through practical application research，explore the e?ect of nasal vestibular cleaning on reducing the inci- dence of respiratory tract infections in the hospital，and provide reference for formulating measures to reduce the incidence ofrespira- tory tract infections in the hospital. Methods：Ninety medical sta? were randomly selected from the high-risk department ofNanjing Hospital A?liated to Nanjing Medical University to be included in the study.For the subjects，observe the headache，cough，fatigue and other cold symptoms of the sampled medical sta? as well as fever and the incidence of nosocomial respiratory tract infections af- ter 6 months.The subjects were tested using iodophor and normal saline to clean the nasal vestibule for 4 hours，and the e?ectiveness of iodophor cleaning the nasal vestibule in reducing nosocomial respiratory infections was studied.Results：In 90 randomly selected subjects，after applying iodophor to clean the nasal vestibule，six months later，the sampled medical sta?s symptoms of cold，such as headache，cough and fatigue，and fever were observed to be lower than those in the group B、C.The reduction level was slightly signi?cant.After 6 months，observe and compare the incidence of nosocomial respiratory tract infections.Iodophor cleaning the na- sal vestibule will reduce the rate of nosocomial respiratory tract infections compared with the B、C group，and the reduction level is slightly signi?cant（P<0.05）.Conclusion：Using iodophor to clean the nasal vestibule can e?ectively reduce the number of fever and colds，indicating that this method provides a reference for formulating measures to reduce hospital respiratory infections.

【Key Words】Iodophor;Nasal colonization;Infection control

医院作为一个存在大量细菌、病毒等病原微生物汇集的场所，不仅来源广泛，而且传播途径广泛。患者的呼吸、咳嗽、排泄物和分泌物等，均带有大量的致病菌，病菌携带者可以通过医务人员的各种医疗活动污染医疗环境和各种医疗器械，较为严重时可导致各种院内感染的发生，成为危害医疗安全最重要的原因之一[1]。……