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脊柱手术中发生手套忽略性穿孔的临床研究OA

Clinical study on neglected perforation of glove during spinal surgery

中文摘要英文摘要

目的 明确脊柱手术使用外科手套的忽略性穿孔发生状况、分布特点及危险因素.方法 选择2022年10月至2024年9月于我院行脊柱手术使用的外科手套932只,统计其忽略性穿孔发生情况及分布位置,对可能导致手套忽略性穿孔的因素分别进行单因素和二元Logistic回归分析.结果 本研究选取的932只脊柱手术使用的外科手套,共检出忽略性穿孔122只(13.09%),其中手套左、右手示指部位忽略性穿孔占比均最高,分别为37.50%和37.93%.单因素和二元Logistic回归分析结果表明:三级或四级手术、开放手术、合并植骨操作、手术时间≥120 min、使用旋转设备和器械护士佩戴的手套为导致忽略性穿孔的危险因素(P<0.05,OR>1.0),而佩戴双层手套为避免忽略性穿孔发生的保护性因素(P<0.05,OR<1.0).结论 脊柱手术中使用外科手套的忽略性穿孔发生率较高,尤其是手套示指部位极易发生忽略性穿孔.对于高风险脊柱手术(三级或四级手术、开放手术、合并植骨操作)且需使用旋转设备时,医护人员,尤其是器械护士,建议佩戴双层手套;此外,建议建立120 min手套更换制度,以降低忽略性穿孔发生率.

Objective To specify the occurrence status,distribution characteristics and risk factors of neglected perforations in surgical gloves used during spinal surgery.Methods A total of 932 surgical gloves used during spinal surgery in our hospital from October 2022 to September 2024 were selected.The occurrence and distribution location of neglected perforations were counted.Univariate and binary Logistic regression analyses were respectively conducted on the factors that might lead to neglected perforations of gloves.Results Among the 932 surgical gloves used in spinal surgery selected in this study,a total of 122 gloves(13.09%)with neglected perforations were detected,of which the proportions of neglected perforations at the index finger of the left and right hands in the gloves were the highest,accounting for 37.50%and 37.93%respectively.The results of univariate and binary Logistic regression analyses showed that grade Ⅲ or Ⅳ surgery,open surgery,combined bone grafting operation,operation time≥120 minutes,use of rotating equipment,and gloves worn by instrument nurses were risk factors for neglected perforations(P<0.05,OR>1.0),while wearing double-layer gloves was a protective factor to avoid the occurrence of neglected perforations(P<0.05,OR<1.0).Conclusion The incidence of neglected perforations in surgical gloves used during spinal surgery is relatively high,especially in the area of the glove index finger.For high-risk spinal surgeries(grade Ⅲ or Ⅳ surgery,open surgeries,combined bone grafting procedures)and requiring rotating equipment,health care workers,especially instrumental nurses,are advised to wear double-layer gloves;furthermore,a 120-minute glove change regime is recommended,in order to reduce the incidence of neglected perforation.

邵晓芳;王博;谭珊珊;何文文;田宇峰

江苏省人民医院宿迁医院麻醉与围术期医学科,江苏 宿迁 223800江苏省人民医院宿迁医院麻醉与围术期医学科,江苏 宿迁 223800江苏省人民医院宿迁医院麻醉与围术期医学科,江苏 宿迁 223800江苏省人民医院宿迁医院麻醉与围术期医学科,江苏 宿迁 223800江苏省人民医院宿迁医院麻醉与围术期医学科,江苏 宿迁 223800

临床医学

脊柱手术外科手套忽略性穿孔分布特点危险因素

spinal surgerysurgical glovesneglected perforationdistribution characteristicsrisk factors

《局解手术学杂志》 2025 (5)

417-420,4

江苏省妇幼健康科研项目(F2021053)

10.11659/jjssx.12E024001

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