负压封闭引流联合腹腔双套管持续冲洗负压引流技术在腹部切口感染中的应用  

Clinical applincation of continuous drainage by double cannula drainage combined with vacuum sealing drainage in the treatment of abdominal incision infection

作　　者：黄子明 葛恒发[1,3] 杨晨晨[1] 毕传昊 HUANG Ziming;GE Hefa;YANG Chenchen;BI Chuanhao(Emergency Surgery,The Affiliated Huaian No.1 People′s Hospital of Nanjing Medical University,Huai′an,Jiangsu 223300,China;Rehabilitation department,The Affiliated Huaian No.1 People′s Hospital of Nanjing Medical University,Huai′an,Jiangsu 223300,China;Department of General Surgery,The Affiliated Huaian No.1 People′s Hospital of Nanjing Medical University,Huai′an,Jiangsu 223300,China)

机构地区：[1]南京医科大学附属淮安第一医院急诊外科,江苏淮安223300 [2]南京医科大学附属淮安第一医院康复科,江苏淮安223300 [3]南京医科大学附属淮安第一医院普通外科,江苏淮安223300

出　　处：《重庆医学》2019年第A01期137-139,共3页Chongqing medicine

摘　　要：目的探讨切口负压封闭引流(VSD)联合腹腔双套管持续冲洗负压引流技术治疗腹部切口感染的效果。方法回顾性分析2013年9月至2018年12月该院急诊外科收治的50例腹部急诊手术发生切口感染患者的临床资料。其中20例行切口VSD联合腹腔双套管持续冲洗负压引流治疗(联合治疗组),15例行单纯普通换药治疗(普通换药组),15例行切口VSD治疗(切口VSD组)。结果联合治疗组患者有效率明显高于普通换药组,差异有统计学意义(P<0.05),而与切口VSD组比较,差异无统计学意义(P>0.05);联合治疗组患者换药次数、切口二次缝合时间、抗生素使用时间均明显优于普通换药组、切口VSD组,切口瘢痕宽度明显小于普通换药,差异均有统计学意义(P<0.05)。结论应用切口VSD联合腹腔双套管持续冲洗负压引流技术能提高腹腔严重感染患者切口愈合率,减少换药次数、切口二次缝合时间及抗生素使用时间,与传统换药比较,能明显抑制术后切口瘢痕增生,值得临床推广应用。Objective To explore the effect of continuous drainage by the double cannula drainage(DCD) combined with vacuum sealing drainage(VSD) in the treatment of abdominal incision infection. Methods Retrospective analysis was conducted of the clinical data on of 50 patients with abdominal incision infection admitted from emergency surgery in Huaian First People′s Hospital from september 2013 to december 2018.Thrty cases were treated with VSD+DCD,Fifty cases were treated with simple dressing change(SDC) and Fifty cases were treated VSD. Results The effective rate(90.0%) of combined group was significantly better than the SDC group.But there was no significant differences(86.7%, P =0.262) with VSD group.The combined treatment group was significantly better in the frequency of dressing change,the duration of incision secondary suture and the duration of antibiotic use compared with SDC and VSD gruoup,the incision scar width of combined group was smaller than that of SDC but not VSD group. Conclusion The combined treatment of VSD and DCD can improve the effection of abdominal incision with severe infection, It is worth popularizing in clinic.

关 键 词：腹部切口感染 腹腔严重感染 双套管持续冲洗 VSD 

分 类 号：R619.3[医药卫生—外科学]