CAJ | 학술논문

目的：探讨鱼骨图和流程图在手术室开放性创伤手术感染中的应用效果，以降低手术时开放性创伤手术的医院感染率。方法2010年1月始医院对开放性创伤手术的感染因素用鱼骨图进行分析并据此设计出流程图并实施；选取2010年1月－2013年6月于医院收治的124例开放性创伤手术患者为观察组，另选取鱼骨图和流程图实施前的138例开放性创伤手术患者为对照组，对两组患者的手术时间、手术出血量、术后感染率、伤口愈合时间、住院时间、患者满意率进行统计及比较。结果对照组手术时间为（5．7±1．8）h、手术出血量为（780±230）ml、住院时间为（24．7±4．5）d、伤口愈合时间为（17．3±5．6）d、术后感染率为30．43％，观察组分别为（2．5±1．3）h、（460±120）ml、（13．5±3．1）d、（8．6±2．6）d、4．84％，两组比较差异均有统计学意义（P＜0．05）。结论在开放性创伤手术感染中应用感染因素鱼骨图和感染管理流程图，可以有效提高开放性创伤手术的护理质量，降低感染的发生率。
목적：탐토어골도화류정도재수술실개방성창상수술감염중적응용효과，이강저수술시개방성창상수술적의원감염솔。방법2010년1월시의원대개방성창상수술적감염인소용어골도진행분석병거차설계출류정도병실시；선취2010년1월－2013년6월우의원수치적124례개방성창상수술환자위관찰조，령선취어골도화류정도실시전적138례개방성창상수술환자위대조조，대량조환자적수술시간、수술출혈량、술후감염솔、상구유합시간、주원시간、환자만의솔진행통계급비교。결과대조조수술시간위（5．7±1．8）h、수술출혈량위（780±230）ml、주원시간위（24．7±4．5）d、상구유합시간위（17．3±5．6）d、술후감염솔위30．43％，관찰조분별위（2．5±1．3）h、（460±120）ml、（13．5±3．1）d、（8．6±2．6）d、4．84％，량조비교차이균유통계학의의（P＜0．05）。결론재개방성창상수술감염중응용감염인소어골도화감염관리류정도，가이유효제고개방성창상수술적호리질량，강저감염적발생솔。
OBJECTIVE To explore the effect of the fishbone diagram and flowchart on reduction of incidence of in‐fections in the patients undergoing open wounds surgery in the operating room so as to reduce the incidence of nos‐ocomial infections due to the open wound surgery .METHODS The fishbone diagram was employed to analyze the factors for the infections by start of Jan ,2010 ,based on which the flowchart was designed and implemented .A to‐tal of 124 patients who underwent the open wound surgery from Jan 2010 to Jun 2013 were chosen as the observa‐tion group ,while 138 patients who underwent the open wounds surgery before the fishbone diagram and flowchart were implemented were assigned as the control group .The operation duration ,intraoperative hemorrhage volume , incidence of postoperative infections ,wound healing time ,length of hospital stay ,and patients′satisfaction were statistically analyzed and compared .RESULTS The operation duration was (5 .7 ± 1 .8) hours in the control group , (2 .5 ± 1 .3) hours in the observation group;the intraoperative hemorrhage volume was (780 ± 230)ml in the con‐trol group ,(460 ± 120)ml in the observation group;the length of hospital stay was (24 .7 ± 4 .5) days in the con‐trol group ,(13 .5 ± 3 .1)days in the observation group;the wound healing time was (17 .3 ± 5 .6)days in the con‐trol group ,(8 .6 ± 2 .6)days in the observation group;the incidence of postoperative infections was 30 .43% in the control group ,4 .84% in the observation group ,and there was significant difference between the two groups (P<0 .05) .CONCLUSION As for the infections due to the open wounds surgery ,the use of fishbone diagram and flow‐chart can effectively improve the nursing quality and reduce the incidence of the infections .