阑尾区注入聚维酮碘预防阑尾切除术后切口感染的研究  

Effect of appendix area injected with povidone iodine on prevention of incision infections after appendectomy

作　　者：刘郁[1] 于亮[1] 耿加敏 段绍斌[1] 

机构地区：[1]新疆医科大学附属中医医院普外一科,新疆乌鲁木齐830000

出　　处：《中华医院感染学杂志》2015年第14期3277-3279,共3页Chinese Journal of Nosocomiology

基　　金：新疆维吾尔自治区重点实验室专项基金资助项目(XJDX0910-2013-6);新疆医科大学科研创新基金资助项目(XJ201186)

摘　　要：目的探讨入腹腔前阑尾区注入聚维酮碘对阑尾切除术后切口感染的影响,指导临床预防阑尾炎术后感染。方法选取2013年1月-2014年1月住院治疗的急性阑尾炎患者176例,将其分为试验组90例和对照组86例,试验组患者在阑尾切除手术入腹腔前阑尾区注入聚维酮碘溶液冲洗浸泡5min,对照组不经该项处理,对比观察两组患者切口愈合及感染率,同时对切口感染患者感染的病原菌进行分析。结果试验组患者切口甲级愈合88例、乙级愈合2例,切口感染率为2.22%,对照组患者切口甲级愈合75例、乙级愈合9例、丙级愈合2例,切口感染率为12.79%,试验组患者的感染率低于对照组;两组患者切口感染病原菌培养鉴定,共分离出70株病原菌,其中试验组分离出5株,均为大肠埃希菌,对照组分离出的65株,其中革兰阳性菌27株占41.54%,革兰阴性菌38株占58.46%;所有病原菌中,大肠埃希菌占41.54%,其次为金黄色葡萄球菌占20.0%。结论在阑尾切除术入腹腔前阑尾区注入聚维酮碘,能杀灭多种导致切口感染致病菌,该方法能有效降低术后切口感染率,预防阑尾切除术后切口感染,值得在临床实施阑尾切除术中推广。OBJECTIVE To observe the impact of the injection of povidone iodine into appendix area on prevention of postoperative incision infections in patients undergoing appendectomy so as to provide guidance for clinical prevention of the postoperative infections.METHODS A total of 176 patients with acute appendicitis who were hospitalized for treatment from Jan 2013 to Jan 20114 were enrolled in the study and divided into the experimental group and the control group with 86 cases.The experimental group was treated with injection of povidone iodine solution into the appendix area for 5min of soaking before the appendectomy was conducted,while the control group was not treated with such procedure.The incision healing and incidence of infections were observed and compared between the two groups of patients,and the pathogens causing the incision infections were analyzed.RESULTS There were 88 patients with grade A incision healing and 2patients with grade B incision healing in the experimental group;there were 75 patients with grade A incision healing,9patients with grade B incision healing,and 2patients with grade C incision healing in the control group.The incidence of incision infections of the experimental group was 2.22%,significantly lower than 12.79% of the control group.Of totally 70 strains of pathogens isolated from the two groups of patients with incision infections,5strains were isolated from the experimental group,all of which were Escherichia coli,and 65 strains were isolated from the control group,of which 41.54%（27strains）were gram-positive bacteria and 58.46%（38strains）were gram-negative bacteria.Of all the pathogens isolated,the E.coli strains accounted for 41.54%,and the Staphylococcus aureus strains accounted for 20.0%.CONCLUSIONThe injection of povidone iodine into the appendix area before the appendectomy can kill a variety species of pathogens causing the incision infections,effectively reduce the incidence of the postoperative incision infections,prevent the incision infections after the appen

关 键 词：聚维酮碘 阑尾炎 病原菌 切口感染 

分 类 号：R619.3[医药卫生—外科学]