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隐匿性手套穿孔:介入放射学操作期间的发生率

Occult glove perforations: frequency during interventional radiologic procedures.

作者信息

Hansen M E, McIntire D D, Miller G L

机构信息

Department of Radiology, University of Texas Southwestern Medical Center, Dallas, 75235-9071.

出版信息

AJR Am J Roentgenol. 1992 Jul;159(1):131-5. doi: 10.2214/ajr.159.1.1609687.

Abstract

Because the intact surgical glove is an important barrier against exposure to blood and other body fluids, occult glove perforations occurring during procedures may have implications for infection control and protection of health care workers. Although the frequency of occult glove perforations during surgery has been studied, no such data have been reported for interventional radiology. This study was designed to determine the frequency of occult glove perforations in interventional radiology. Gloves used during interventional radiologic procedures were collected and tested for occult perforations according to previously accepted methods. The frequency of occult defects in unused gloves was also determined. A form completed for each pair of gloves indicated length of use, awareness of perforations, and information about the procedure. The anatomic distribution of perforations was also studied. Occult perforations were found in 49 (10%) of 492 used gloves. The frequency of defects in unused gloves was 1% (2/160). Gloves worn fewer than 2 hr had a perforation rate of 7% (29/406), and those worn 2 hr or longer had a rate of 23% (20/86; p less than .0001). Perforations were noticed by the wearer in only three (6%) of the 49 perforations. The perforation rate for inner gloves of a double-glove set was 3% (1/34; the corresponding outer glove also was perforated). Although the 10% rate of occult glove perforation during interventional radiologic procedures found in this series is lower than rates described with surgical procedures, it is not insignificant. The significant increase in the rate of perforation when gloves are worn more than 2 hr suggests that gloves should routinely be changed at or before 2 hr of wear, particularly in procedures involving high-risk patients.

摘要

由于完整的手术手套是防止接触血液和其他体液的重要屏障,手术过程中发生的隐匿性手套穿孔可能会对感染控制和医护人员的防护产生影响。虽然已经对手术期间隐匿性手套穿孔的发生率进行了研究,但介入放射学方面尚无此类数据报告。本研究旨在确定介入放射学中隐匿性手套穿孔的发生率。收集介入放射学操作中使用的手套,并根据先前公认的方法检测隐匿性穿孔。还确定了未使用手套的隐匿性缺陷发生率。为每双手套填写一份表格,注明使用时间、对穿孔的知晓情况以及有关操作的信息。还研究了穿孔的解剖分布情况。在492只使用过的手套中,发现49只(10%)有隐匿性穿孔。未使用手套的缺陷发生率为1%(2/160)。佩戴时间少于2小时的手套穿孔率为7%(29/406),佩戴2小时或更长时间的手套穿孔率为23%(20/86;p<0.0001)。在49处穿孔中,只有3处(6%)被佩戴者注意到。双层手套套装中内层手套的穿孔率为3%(1/34;相应的外层手套也有穿孔)。尽管本系列研究发现介入放射学操作期间隐匿性手套穿孔率为10%,低于手术操作中描述的发生率,但并非微不足道。当手套佩戴超过2小时时穿孔率显著增加,这表明手套应在佩戴2小时时或之前常规更换,尤其是在涉及高危患者的操作中。

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