两种冲洗液对预防老年消化道穿孔患者术后切口感染的效果评价  

Effects of two kins of rinse solutions on prevention of postoperaive incision infections in elderly patients with digestive tract perforation

作　　者：付庆华[1] 郭爱华[1] 谢太普 李欣[1] 潘虹[1] FU Qing-hua GUO Ai-hua XIE Tai-pu LI Xin PAN Hong(Liaocheng People＇s Hospital, Liaocheng, Shandong 252000,Chin)

机构地区：[1]聊城市人民医院西区手术室,山东聊城252000

出　　处：《中华医院感染学杂志》2017年第12期2756-2759,共4页Chinese Journal of Nosocomiology

基　　金：山东省医药卫生科技发展计划基金资助项目(2014WS0300)

摘　　要：目的探索两种冲洗液对预防老年消化道穿孔患者术后切口感染的效果评价。方法选择医院2013年9月-2016年2月收治123例消化道穿孔行手术治疗的老年患者,分为观察组61例与对照组62例,对照组于术后采用生理盐水冲洗腹腔及手术切口,观察组采用甲硝唑溶液及双氧水溶液冲洗腹腔及手术切口;观察两组患者预防切口感染的效果,记录切口愈合与疼痛持续时间、下地行走时间、白细胞恢复时间。结果观察组切口甲级愈合率为80.33%,切口感染率最低11.48%,明显优于对照组(P<0.05);比较两组患者术后情况,发现观察组切口愈合与切口疼痛持续时间、下地行走时间、白细胞恢复时间均明显低于对照组(P<0.05);28例切口感染患者切口分泌物共培养出病原菌36株,其中革兰阳性菌15株占41.67%,革兰阴性菌21株占58.33%。结论采用两种冲洗液可有效改善老年消化道穿孔患者术后的切口愈合程度,减少切口感染的发生,明显提高术后恢复情况。OBJECTIVE To explore the effects of two kinds of rinse solutions on prevention of postoperaive incision infections in eldelry patients with digestive tract perforation.METHODS A total of 123 eldely patients with digestive tract perforation who received surgical procedures in the hospital from Sep 2013 to Feb 2016 were enrolled in the study and divided into the observation group with 61 cases and the control group with 62 cases.The control group was given postoperative irrigation of abdominal cavity and surgical incision with normal saline,and the observation group was given irrigation of abdoiominal cavity and surgical incision with metronidazole solution and hydrogen peroxide solution.The effect on prevention of incision infection was observed;the incision healing time,duration of pain,time of walking,and time of recovery of white blood cells were recorded.RESULTS The grade A incision healing rate of the observation group was 80.33%,significantly higher than that of the control group;the incidence rate of incision infection of the observation group was 11.48%,significantly lower than that of the control group （P〈0.05）.The incision healing time,duration of pain,time of walking,and time of recovery of white blood cells were significantly shorter in the observation group than in the control group （P〈0.05）.Totally 36 strains of were isolated from incision secretions of 28 patients with incision infection,of which 15 （41.67%） were gram-positive bacteria,and 21 （58.33 %） were gram-negative bacteria.CONCLUSION The two kinds of rinse solutions may effectively improve the postoperative incision healing degree of the elderly patients with digestive tract perforation,reduce the incidence of incision infections,and remarkably improve the postoperative recovery.

关 键 词：冲洗液 老年 消化道穿孔 切口感染 

分 类 号：R656.1[医药卫生—急诊医学]