三腔管负压持续灌洗引流减少胃肠术后腹腔内感染的效果评价  

Evaluation on effect of continuous lavage and drainage under negative pressure by three-channel tube in reducing intra-abdominal infection after gastrointestinal surgery

作　　者：曾和英[1] 何建群[1] 谢乐天[1] 沈建国[2] 

机构地区：[1]丽水市人民医院普外三病区,浙江丽水323000 [2]浙江大学医学院附属邵逸夫医院,浙江杭州310016

出　　处：《中华医院感染学杂志》2014年第7期1750-1752,共3页Chinese Journal of Nosocomiology

基　　金：浙江省科技厅医药基金项目(2011KYA086)

摘　　要：目的探讨三腔管负压持续灌洗引流减少胃肠术后腹腔内感染的效果,为胃肠术后腹腔内感染治疗提供参考。方法选取2011年3月-2013年5月医院胃肠手术后行腹腔引流患者72例,按其引流方式随机分为观察组和对照组,每组各36例,对照组采用传统橡胶引流,观察组采用硅胶三腔管负压持续灌洗引流,对两组患者腹腔内感染、细菌分布、引流量、引流时间以及引流管堵塞情况进行观察比较,数据采用SPSS16.0软件进行分析。结果 72例患者细菌培养阳性21例,其中观察组6例,阳性率为16.67%,对照组15例,阳性率为41.67%,观察组低于对照组,差异有统计学意义(P<0.05);腹腔感染送检标本检出病原菌23株,观察组检出8株、对照组检出15株;观察组与对照组检出病原菌均以葡萄球菌属为主,分别占37.50%与60.00%,观察组引流液变清时间、引流管拔管时间、总置管时间、日均引流量等均显著优于对照组,两组比较差异有统计学意义(P<0.05)。结论对胃肠手术患者于术后行三腔管负压持续引灌洗引流,能提高引流效果、缩短引流时间、减少腹腔内感染的发生、提高治疗效果。OBJECTIVE To investigate the effect of continuous lavage and drainage under negative pressure by three-channel tube in reducing intra-abdominal infection gastrointestinal surgery and provide reference for treat-ment of intra-abdominal infection after gastrointestinal surgery .METHODS A total of 72 patients who underwent abdominal drainage after gastrointestinal surgery in our hospital from Mar .2011 to May 2013 were selected and divided into the observation group and the control group ,with 36 cases in each group .The control group received conventional rubber drainage ,the observation group received lavage and drainage under negative pressure by three-channel silicone tube .Intra-abdominal infection ,bacterial distribution ,drainage amount ,drainage time and drain-age tube blockage were observed and compared between the two groups .The data were analyzed by SPSS 16 .0 software .RESULTS The bacterial culture was positive in 21 patients among the total 72 patients ,including six patients detected in the observation group （the detection rate of 16 .67% ） and 15 patients in the control group （41 .67% ） .The detection rate was lower in the observation group than in the control group .Twenty-three patho-gens of abdominal infection were detected in the examined samples ,including 8 strains in the observation group , which was significant lower than in the control group in which 15 strains were detected （P＆lt; 0 .05） .The main pathogen was Staphylococcus in both the observation group （37 .50% ） and the control group （60 .00% ） .The time to clear drainage fluid ,estuation time of the drainage tube ,total catheterization time ,average daily drainage in the observation group were significantly better than in the control group （P＆lt;0 .05） .CONCLUSION Continuous lavage and drainage under negative pressure by three-channel tube after gastrointestinal surgery can improve the drainage effect ,reduce drainage time ,reduce the incidence of intra-abdominal infection ,and improve the therapeu-tic effect

关 键 词：硅胶三腔管 负压持续灌洗引流 橡胶引流 胃肠术 腹腔内感染 

分 类 号：R619.3[医药卫生—外科学]