不同引流方式在腹部手术感染切口治疗中的应用  

Application of different drainage modes in treatment of abdominal surgical incision infections

作　　者：石穗岩[1] 张曙光[1] 王明海[1] 

机构地区：[1]山东省千佛山医院血管外科,山东济南250014

出　　处：《中华医院感染学杂志》2015年第9期2074-2076,共3页Chinese Journal of Nosocomiology

基　　金：山东省自然科学基金资助项目(ZR2009CL018)

摘　　要：目的对比分析可冲洗负压封闭引流与传统负压封闭引流在腹部手术感染切口治疗中的应用效果,为临床治疗提供参考依据。方法选取普外科2003年10月-2013年10月收治的76例切口感染患者,将患者随机分为试验组与对照组,各38例;对照组接受传统的负压封闭引流,试验组接受可持续冲洗负压封闭引流,对比分析两组伤口的愈合及负压封闭引流的使用情况。结果共检出病原菌76株,其中革兰阴性菌65株占85.5%,革兰阳性菌11株占14.5%;试验组伤口清洁时间(6.3±1.9)d、伤口换药次数(1.9±0.5)次、伤口愈合时间(15.3±4.2)d,对照组分别为(8.7±1.5)d、(3.1±0.7)次、(19.1±3.7)d,两组比较差异均有统计学意义(P<0.01);试验组负压引流的平均使用时间为(6.5±1.7)d、切口处的细菌计数为(247±158)CFU/cm2,对照组分别为(2.6±1.3)d、(5 318±1 942)CFU/cm2,两组比较差异均有统计学意义(P<0.01)。结论可冲洗负压封闭引流能促进腹部手术感染切口的愈合,减少换药次数,其效果优于传统的负压封闭引流,值得在临床推广应用。OBJECTIVE To observe and compare the effects of the flushable vacuum sealing drainage （VSD） and conventional VSD on treatment of abdominal surgical incision infections so as to provide guidance for the clinical treatment .METHODS A total of 76 patients with hospital‐acquired incision infections who were treated in the gen‐eral surgery department from Oct 2003 to Oct 2013 were enrolled in the study and randomly divided into the exper‐imental group and the control group ,with 38 cases in each;the control group received the conventional VSD ,and the experimental group received the flushable VSD ;the wound healing and the use of VSD were observed and compared between the two groups .RESULTS A total of 76 strains of pathogens have been isolated ,including 65 （85 .5% ） strains of gram‐negative bacteria and 11 （14 .5% ） strains of gram‐positive bacteria .The wound cleaning time was （6 .3 ± 1 .9）days in the experimental group ,（8 .7 ± 1 .5）days in the control group;the frequency of wound drug dressing was （1 .9 ± 0 .5）times in the experimental group ,（3 .1±0 .7）times in the control group ;the wound healing time was （15 .3 ± 4 .2）days in the experimental group ,（19 .1 ± 3 .7）days in the control group ,there was significant difference between the two groups （P〈0 .01） .The average time of vacuum drainage was （6 .5 ± 1 .7）days in the experimental group ,（2 .6 ± 1 .3）days in the control group;the bacterial colony counts on the in‐cision site were （247 ± 158）CFU/cm2 in the experimental group ,（5 318 ± 1 942）CFU/cm2 in the control group , there was significant difference between the two groups （P〈0 .01） .CONCLUSION The flushable VSD can facili‐tate the healing of abdominal surgical incision and reduce the frequency of drug dressing ,and it is superior to the conventional VSD and is worthy to be promoted in the hospital .

关 键 词：可冲洗负压封闭引流 感染切口 临床疗效 

分 类 号：R619.3[医药卫生—外科学]