外伤性肝破裂患者感染预防的临床研究  

Clinical study on infection prevention of patients with traumatic hepatic rupture

作　　者：周锐[1] 刘峰[1] 王建祥[1] 

机构地区：[1]华中科技大学同济医学院附属普爱医院普外科,湖北武汉430033

出　　处：《中华医院感染学杂志》2014年第24期6168-6170,共3页Chinese Journal of Nosocomiology

基　　金：湖北省卫生厅基金资助项目(HW-2011B-020)

摘　　要：目的分析外伤性肝破裂患者应用损伤控制性手术治疗的意义及膈下感染的预防,为临床诊断治疗提供依据。方法选择2006年7月-2013年7月外伤性肝破裂患者47例,按照治疗方法分为对照组23例与观察组24例;对照组行一期确定性手术,观察组行损伤控制性手术;分析对比两组手术成功率、手术时间、体温恢复时间、PT与APTT恢复时间、住院时间、出血量,术后医院感染及并发症,采用SPSS17.0进行统计分析。结果观察组损伤控制性手术成功率95.83%显著高于对照组56.52%;观察组手术时间、体温恢复时间、PT及APTT恢复时间均显著低于对照组;观察组切口感染率4.17%、膈下感染率4.17%显著低于对照组切口感染率30.43%、膈下感染率34.78%,差异均有统计学意义(P<0.05)。结论外伤性肝破裂应用损伤性手术治疗成功率较高、手术时间短且并发症少,可简单、有效且快速的进行止血,并做好术后在医院感染的预防措施,具有重要临床研究价值。OBJECTIVE To analyze the significance and infection prevention of damage control surgery using in patients with traumatic hepatic rupture so as to provide the basis for clinical diagnosis and treatment .METHODS From Jul .2006 to Jul .2013 ,a total of 47 patients with traumatic hepatic rupture were divided into control group （23 cases） and observation group （24 cases） according to different therapies .The control group underwent a peri‐od to determine the operation ,the observation group received damage control operation .The success rate ,opera‐tion time ,recovery time of body temperature ,PT and APTT recovery time ,hospitalization time ,bleeding vol‐ume ,postoperative nosocomial infections and complications of the two groups were comparatively analyzed .SPSS 17 .0 was adopted for a statistical analysis .RESULTS The success rate of damage control operation was 95 .83% in the observation group ,which was significantly higher than that of the control group （56 .52% ） .The operative time ,temperature recovery time ,PT and APTT recovery time in the observation group was significantly lower than that of the control group .The incision infection rate（4 .17% ） and subphrenic infection rate （4 .17% ） in the observation group was significantly lower than that of the control group （30 .43% ,34 .78% ） （P＆lt; 0 .05） . CONCLUSION The application of damage control surgery has higher success rate ,fewer complications ,and shor‐ter operative time in treating traumatic hepatic rupture .It can simply ,efficiently and quickly stop the bleeding . Good infection prevention measures after operations have important clinical research values .

关 键 词：外伤性肝破裂 损伤控制性手术 临床研究 感染预防 

分 类 号：R181.32[医药卫生—流行病学]