两步法与六步法卫生手消毒的效果比较: 一项随机对照交叉试验

Efficacy of two-step and six-step hygienic hand disinfection: a randomized controlled cross-over trial

摘要:

目的 探讨简化版两步法卫生手消毒与《WHO医疗机构手卫生指南》推荐的六步法卫生手消毒对医务人员手部自然菌的去除效果有无差异。 方法 采用随机对照交叉试验方法对某三级甲等综合性医院的32名临床医护人员进行随机分组，试验组采用两步法，对照组采用六步法，前后两个阶段相互交叉进行试验，间隔一天洗脱期，比较卫生手消毒前后两组医务人员手部自然菌的平均杀灭对数值。 结果 试验组与对照组医务人员卫生手消毒后的平均杀灭对数值均>1，消毒效果均合格，两组医务人员卫生手消毒后菌落数下降量均有统计学意义（均P < 0.001）；比较两种卫生手消毒方法对细菌的平均杀灭对数值，差异无统计学意义（P=0.973）。 结论 两步法卫生手消毒与六步法卫生手消毒效果一致，且两步法耗时更短，效率更高，值得临床推广。

Abstract:

Objective To explore whether there is any difference between the simplified two-step hygienic hand disinfection and the six-step hygienic hand disinfection method recommended in the WHO guidelines for hand hygiene in health care. Methods 32 clinical health care workers (HCWs) in a tertiary general hospital were grouped randomly by randomized controlled cross-over trial, two-step method was adopted in trial group and six-step method was adopted in control group, trial was crossly conducted with each other between two periods, with an interval of one day, the average killing logarithm of natural bacteria on hands of two groups of HCWs before and after hygienic hand disinfection was compared. Results The average killing logarithm values after HCWs' hygienic hand disinfection in trial group and control group were both >1, disinfection effect were both qualified, the decrease of colony number after hygienic hand disinfection of HCWs in two groups were both statistically significant (both < 0.001); there was no significant difference in the average killing logarithm of bacteria between two kinds of hygienic hand disinfection (P=0.973). Conclusion The effect of two-step hygienic hand disinfection is the same as that of six-step hygienic hand disinfection, two-step method takes less time and has higher efficiency, which is worthy of clinical promotion.