负压封闭引流创面冲洗频次对堵管及细菌清除率的影响  

Effect on tube blocking and bacteria clearance of rinsing wounds with vacuum sealing drainage(VSD)at different frequencies

作　　者：夏冬云[1] 史婷奇[1] 谢芳[1] 刘晴[1] 

机构地区：[1]南京大学医学院附属鼓楼医院整形烧伤科,江苏南京210008

出　　处：《护理学杂志》2014年第16期1-3,共3页

基　　金：2010年度国家临床重点专科护理建设项目

摘　　要：目的探讨负压封闭引流治疗新鲜创面和感染创面的最佳冲洗频次,以防范堵管,促进创面愈合。方法选择167例(180处创面)行创面生理盐水负压封闭引流术患者,将其中90处新鲜创面随机分为不冲洗组30处,隔日冲洗组30处,每日冲洗组30处;90处感染创面随机分为每日冲洗1次组30处,每日冲洗2次组30处,每日冲洗3次组30处,观察堵管率和创面细菌清除率。结果新鲜创面:隔日冲洗组和每日冲洗组均未发生堵管,不冲洗组堵管率26.67%;三组不同干预时间创面细菌计数比较,干预主效应、时间效应和交互效应差异有统计学意义(均P<0.01),细菌清除率隔日冲洗(98.79%)和每日冲洗组(99.17%)高于不冲洗组(90.79%)。感染创面:三组堵管率比较差异有统计学意义(P<0.05);三组不同干预时间创面细菌计数比较,干预主效应、时间效应和交互效应差异有统计学意义(均P<0.01);细菌清除率每日冲洗2次组(99.34%)和每日冲洗3次组(99.49%)高于每日冲洗1次组(94.62%)。结论新鲜创面选择隔日冲洗、感染创面选择每日冲洗2次,可有效减少堵管发生率,保证持续负压治疗的有效性,且相对经济、节约护理人力。Objective To explore the best rinsing frequency for fresh or infected wounds treated with VSD,to avoid tube blocking and improve work efficiency.Methods A total of 180 wounds （167 patients treated with VSD） were included in this study.The patients were divided into two groups according to their different wounds：90 infected and 90 fresh wounds.The fresh wounds group was further divided into 3 sub-groups：30 of the no-rinsing,daily rinsing and rinsing-every-2-days sub-groups,while the infected group consisted of 3 subgroups：30 of the one rinsing/day,two rinsings/day and three rinsings/day.The rates of tube blocking and bacteria clearance on the wounds were observed.Results In the fresh wounds group,there was no blocking in two rinsing sub-groups,while the blocking rate of the no-rinsing was 26.67 % ; concerning bacteria counting,the difference in group,time and group by time effect of different interventions was of significance（P〈0.01 for all）; as for the bacteria clearance rate,there was significant difference between daily rinsing （99.17 %） or rinsing-every-2-days （98.79%） and no-rinsing （90.79%） sub-group.In the infected group,the difference in blocking rate was of statistical significance among the three subgroups （P〈0.05）.Concerning bacteria counting,the difference in group,time and group by time effect of intervention was of significance （P〈 0.01 for all）; as for the bacteria clearance rate,the two rinsings/day （99.34 %）and three rinsings/day（99.49 %） sub-groups were much better than the one rinsing/day （94.62 %）.Conclusion Rinsing fresh wounds once every two days and infected wounds twice/day can decrease the rate of tube blocking and ensure the effectiveness of VSD treatment efficiently and economically.

关 键 词：负压封闭引流术 新鲜创面 感染创面 创面冲洗 堵管 细菌清除率 

分 类 号：R473.6[医药卫生—护理学]