Tichenor J R, Miller R C, Wolf E J
Department of Obstetrics and Gynecology, National Naval Medical Center, Bethesda, Maryland.
Am J Perinatol. 1994 Sep;11(5):359-61. doi: 10.1055/s-2007-994555.
A prospective cross-sectional study was designed to determine the rates of upper facial splash during obstetric deliveries. Macroscopic splashes on the attached eye shields of surgical masks, worn for obstetric deliveries were enumerated for a sample of parturients during a 3-month period. Masks were collected for 68 vaginal and 44 cesarean deliveries, 31% of all deliveries during the study period. For cesarean deliveries, 68% (30) of all masks worn by primary surgeons had at least one splash; 57% (17) of which were heavily contaminated (more than five splashes). For the first assistant, 68% (30) of all masks had at least one splash; 23% (7) of which were heavily contaminated. During vaginal deliveries 44% (30) of masks worn by the delivering physician had at least one splash; 20% (6) of which were heavily contaminated. The primary surgeon in a cesarean section was 1.6 times as likely to be splashed (P < 0.04) when compared with vaginal deliveries and 4.6 times as likely to be heavily contaminated (P < 0.003). Estimated blood loss and the rate of eye splash were linearly related. Method of delivery was not independently associated with eye splash. These findings suggest that the risk of contamination by splash during obstetric procedures is high, particularly for cesarean deliveries because these deliveries tend to have greater blood losses.
一项前瞻性横断面研究旨在确定产科分娩过程中面部上方溅污的发生率。在3个月的时间里，对一部分产妇佩戴的用于产科分娩的手术口罩上附着的眼罩上的肉眼可见溅污进行了计数。收集了68例阴道分娩和44例剖宫产分娩时佩戴的口罩，占研究期间所有分娩的31%。对于剖宫产分娩，主刀医生佩戴的所有口罩中有68%（30个）至少有一处溅污；其中57%（17个）被严重污染（溅污超过5处）。对于第一助手，所有口罩中有68%（30个）至少有一处溅污；其中23%（7个）被严重污染。在阴道分娩过程中，接生医生佩戴的口罩中有44%（30个）至少有一处溅污；其中20%（6个）被严重污染。剖宫产的主刀医生被溅污的可能性是阴道分娩的1.6倍（P<0.04），被严重污染的可能性是阴道分娩的4.6倍（P<0.003）。估计失血量与眼部溅污率呈线性相关。分娩方式与眼部溅污无独立关联。这些发现表明，产科手术过程中因溅污而受到污染的风险很高，尤其是剖宫产，因为这些分娩往往失血量更大。
