术中及术后短时高浓度吸氧对腹部污染手术切口的影响  

Effect of supplemental peri-and post-operative oxygen on abdominal contaminated wound infection.

作　　者：王兴祥[1] 陆文佐[1] 吴胜英[1] 王谊生[2] 玉珠[3] 章璞[1] 王勇[1] 郭杰[1] 陈冶[1] 励雄年[1] 俞晓村[1] 王亚瑛[1] 

机构地区：[1]上海市浦南医院普外科,200125 [2]上海市浦南医院麻醉科,200125 [3]上海市浦南医院检验科,200125

出　　处：《中国实用外科杂志》2004年第11期691-693,共3页Chinese Journal of Practical Surgery

基　　金：上海市浦东新区社会发展局医学科研基金资助项目 (PW 2 0 0 3 A9)

摘　　要：目的　探讨手术中、手术后短时间高浓度氧疗对腹部污染手术切口感染的影响。方法　 2 0 0 1年 1月至 2 0 0 3年 4月行腹部污染手术 196例 ,随机分组。手术开始至术后 2h内观察组 (98例 )用防漏面罩供氧 (FiO26 0 % ) ,对照组 (98例 )用鼻导管供氧 (FiO2 2 8% )。除阑尾手术外术后 2h抽股动脉血测定血气分析 ,均测定末梢动脉血氧饱和度 ,记录有无氧中毒表现。观察切口至术后 15d ,切口丙级愈合为切口感染。结果　两组无氧中毒表现。术后 2h动脉血气分析 ,观察组PaO2 为 (16 5 3± 38 6 )mmHg ,对照组为 (118 1± 2 9 4 )mmHg ,两组比较 P<0 0 0 1。术后末梢动脉血氧饱和度两组均正常。观察组切口感染 5例 (5 1% ) ,对照组 14例 (14 3% ) ,两组比较P <0 0 5。结论　手术中、手术后短时间高浓度氧疗可减少腹部污染手术切口感染。Objective To explore the effect of peri-and post-operative administration of supplemental oxygen on abdominal contaminated surgical wound infection. Methods From January 2001 to April 2003, 196 patients undergoing abdominal contaminated operation were randomly divided into two groups to receive FiO 260% (n=98, study group) or FiO 228% (n=98, control group) inspired oxygen during the operation and two hours postoperatively. The partial pressure of oxygen in arterial blood and the peripheral arterial oxygen saturation was measured within two hours after operation. During postoperative 15 days, the wounds with drained pus were considered to be infected. Results The results showed that the partial pressure of oxygen in arterial blood in study group was significantly higher than that in control group (P<0.001) and the peripheral arterial oxygen saturation was normal in both groups. Five(5.1%) patients receiving 60% oxygen had surgical wound infection, as compared with 14(14.3%) patients receiving 28% oxygen (P<0.05). Conclusion Supplemental perioperative oxygen can reduce the incidence of abdominal contaminated surgical wound infection.

关 键 词：短时高浓度吸氧 腹部切口污染 腹部手术 切口感染 

分 类 号：R656[医药卫生—外科学] R619.3[医药卫生—临床医学]