肠穿孔腹腔感染肠造口术的应用研究  

Application of enterostomy in treatment of bowel perforation complicated with abdominal cavity infections

作　　者：乔小平[1] 张桂华[1] 陈名林[1] 

机构地区：[1]聊城市人民医院,山东聊城252000

出　　处：《中华医院感染学杂志》2015年第18期4243-4245,共3页Chinese Journal of Nosocomiology

基　　金：山东省科技厅科研基金资助项目[JB(S)2012-3-40B5]

摘　　要：目的探讨肠造口术在肠穿孔并发腹腔感染中的应用价值,以降低临床肠穿孔并发腹腔感染的发生率。方法选取2012年1月-2014年1月医院收治的80例肠穿孔腹腔感染患者,将其分为治疗组50例行肠造口术,对照组30例行腹腔开放疗法,对比两组患者术前及术后10d血清C-反应蛋白(CRP)、血清降钙素原(PCT)、白细胞(WBC)计数水平和APACHEⅡ评分情况,同时对两组患者的病死率、住院时间、手术时间及术后首次排气时间进行比较。结果术后10d治疗组的CRP、PCT及WBC水平均低于对照组,手术4d后治疗组患者的APACHEⅡ分级均低于对照组;治疗组病死率为0,对照组病死率为3.3%;治疗组的病死率、手术时间、住院时间均低于对照组,两组比较差异均有统计学意义(P<0.05);两组的术后首次排气时间相近,差异无统计学意义。结论肠造口术具有操作简单、经济、安全、恢复快等优点,可从根源上切断腹腔感染,值得在肠穿孔并发腹腔感染的应用中推广。OBJECTIVE To analyze the application value of enterostomy in treating bowel perforation complicated with abdominal cavity infections so as to reduce the infection rate.METHODS Totally 80 patients with intestinal perforation complicated by abdominal cavity infections between Jan.2012 and Jan.2014 in our hospital were selected and divided into the treatment group（50cases,enterostomy）and the control group（30cases,open abdominal cavity therapy）.Two groups of patients were compared for serum C-reactive protein（CRP）and serum calcitonin（PCT）,white blood cell count（WBC）levels and APACHE Ⅱ grading preoperatively and at 10 dpostoperatively.Meanwhile,two groups of patients were compared for mortality,length of hospital stay,operation time and postoperative first farting time.RESULTS CRP and PCT and WBC levels were lower in the treatment group than in the control group at postoperative 10 dand the APACHE Ⅱ grade at 4dwas lower in the treatment group than in the control group.The mortality was 0in the treatment group and 3.3% in the control group.Mortality,length of hospital stay and operation time were significently lower in the treatment group than in the control group（P〈0.05）.There was no significant difference in the postoperative first farting time between the two groups.CONCLUSIONEnterostomy is simple to operation,economical,safe and fast to recover which can cut off abdominal cavity infections from sources and is worthy promoting in the treatment of bowel perforation complicated with abdominal cavity infections.

关 键 词：肠造口术 肠穿孔 腹腔感染 C-反应蛋白 血清降钙素原 白细胞计数 急性生理和慢性健康评分 

分 类 号：R181.32[医药卫生—流行病学]