围术期辅助供氧治疗对跟骨骨折手术术后切口感染的影响  

Influence of perioperative adjuvant oxygen therapy on postoperative incision infections in patients with calcaneus fractures

作　　者：章晓泽 陈天勇 范雯[3] 陈奇涵 沈文生[5] 

机构地区：[1]诸暨市第六人民医院麻醉科,浙江诸暨311800 [2]诸暨市中医院麻醉科,浙江诸暨311800 [3]浙江大学医学院附属第二医院麻醉科,浙江杭州310000 [4]诸暨市中心医院麻醉科,浙江诸暨311800 [5]绍兴市中医院麻醉科,浙江绍兴312000

出　　处：《中华医院感染学杂志》2017年第10期2294-2297,共4页Chinese Journal of Nosocomiology

基　　金：浙江省医学会临床科研基金资助项目(2014ZYC-A02)

摘　　要：目的探讨辅助供氧治疗对跟骨骨折手术术后切口感染的影响,以期为跟骨骨折术后切口感染预防措施的选择提供参考。方法选取医院2013年9月-2016年8月择期行跟骨骨折切开复位内固定术的患者226例,随机分为试验组和对照组,每组各113例;实施全身麻醉后,试验组将氧浓度调整至80%,对照组将氧浓度调整至30%,氧流量2L/min,记录两组患者术后14d内手术部位感染、创口边缘坏死、跟骨骨髓炎、因感染再次手术的发生率,并记录患者术后肺不张、术后肺部感染发生情况。结果试验组患者术后14d手术部位感染4例,感染率为3.5%,对照组手术部位感染12例,感染率为10.6%,试验组患者术后14d手术部位感染率明显低于对照组(P<0.05);试验组术后14d创口边缘坏死共7例(6.1%),而对照组创口边缘坏死共19例(16.8%),两组比较差异有统计学意义(P<0.05);试验组患者因感染再次手术3例(2.7%),对照组因感染再次手术共10例(8.8%),试验组患者因感染再次手术率明显低于对照组(P<0.05);试验组与对照组患者跟骨骨髓炎发生率差异无统计学意义。结论围术期辅助供氧治疗能够显著降低跟骨骨折患者术后切口感染率且不增加肺部并发症发生率;在预防切口感染及其相关并发症方面具有明显优势,值得推广应用。OBJECTIVE To explore the influence of adjuvant oxygen therapy on postoperative incision infections in patients with calcaneus fractures so as to provide guidance for prevention of the postoperative incision infections in the patients with calcaneus fractures.METHODS A total of 226 patients who underwent open reduction and internal fixation of calcaneal fractures in hospitals from Sep 2013 to Aug 2016 were enrolled in the study and randomly divided into the experimental group and the control group,with 113 cases in each group.After the general anesthesia,the oxygen concentration was adjusted to 80% in the experimental group and 30% in the control group,with the oxygen flow 2 L/min.The incidence rates of surgical site infections,wound edge necrosis,calcaneal osteomyelitis,and reoperation due to infections were recorded within 14 days after the surgery;the incidence of postoperative pulmonary atelectasis,postoperative pulmonary infections were recorded.RESULTS The surgical site infections occurred in 4 cases in the experimental group after the surgery for 14 days,with the infection rate 3.5%;the surgical site infections occurred in 12 cases in the control group,with the infection rate 10.6 %;the incidence rate of surgical site infections of the experimental group was significantly lower than that of the control group after the surgery for 14 days （P〈0.05）.Totally 7 （6.1%） patients had wound edge necrosis in the experimental group after the surgery for 14 days,19 （16.8%） patients in the control group,and there was significant difference between the two groups （P〈0.05）.Totally 3 （2.7%） patients received surgery once again due to infections in the experimental group,10 （8.8%） patients in the control group,and the rate of reoperation due to infections was significantly lower in the experimental group than in the control group （P%0.05）.There was no significant difference in the incidence rate of calcaneal osteomyelitis between the experimental group and the control group.CONCLUSION The per

关 键 词：围术期 辅助供氧 感染 

分 类 号：R378[医药卫生—病原生物学]