皮下引流持续冲洗负压吸引术在肠造口还纳术后预防切口感染的前瞻性研究  

Subcutaneous drainage tube with continuous irrigation and vacuum suction after enterostomy to reduce surgical site infection:A prospective study

作　　者：曹金鹏[1] 计勇[1] 杨平[1] 余思[1] 李志澄[1] 张健[1] 罗特东[1] Cao Jinpeng;Ji Yong;Yang Ping;Yu Si;Li Zhicheng;Zhang Jian;Luo Tedong(Department of Gastrointestinal Surgery,the First People’s Hospital of Foshan,Foshan 528000,China)

机构地区：[1]佛山市第一人民医院胃肠外科,528000

出　　处：《中华普通外科学文献（电子版）》2020年第2期125-128,共4页Chinese Archives of General Surgery(Electronic Edition)

基　　金：广东省佛山市医学类科技攻关基金项目(2016AB002591)。

摘　　要：目的探讨皮下引流持续冲洗负压吸引术在结直肠癌手术并肠造口患者行还纳术后预防切口感染的应用价值。方法前瞻性选择2017年2月至2018年12月佛山市第一人民医院收治的100例肠造口患者,按照随机数字表法分成两组,在肠造口还纳术中关闭切口时采用不同措施,每组50例,试验组采用皮下引流持续冲洗负压吸引装置,对照组采用传统关闭切口方法。比较两组患者的围手术期资料以及术后切口感染率。结果两组患者均采取开腹手术,无一例围手术期死亡。两组造口类型、初次造口时机、造口时间、手术时间、术中出血量比较,差异均无统计学意义。试验组患者术后住院时间为(7.0±5.7)d,术后切口感染率为2.0%(1/50),显著低于对照组的(9.5±5.6)d、16.0%(8/50),差异有统计学意义(t=-2.193,P=0.031;χ2=4.396,P=0.036)。结论皮下引流持续冲洗负压吸引术能有效降低结直肠癌肠造口还纳术患者的切口感染发生率,缩短住院时间,临床应用价值较高。Objective To explore the application value of subcutaneous drainage tube with continuous irrigation and vacuum suction after enterostomy to reduce surgical site infection.Methods One hundred patients with enterostomy from February 2017 to December 2018 were randomized into two groups with different wound closure techniques in stoma reversal,with 50 cases in each group.Patients in the trial group were placed subcutaneous drainage tube with continuous irrigation and vacuum suction when the skin was closed.Patients in the control group were assigned to undergo conventional skin closure.The terms of perioperative clinical data and surgical site infection rates were recorded and analyzed.Results All patients in the two groups underwent laparotomy,and none of them died during the perioperative period.There were no significant differences between the groups in terms of stoma type,stoma indication,stoma reversal duration,operative time,and blood loss.The hospitalization time was(7.0±5.7)d and the incidence of incision infection was 2.0%(1/50)in the trial group,which were significantly lower than(9.5±5.6)d and 16.0%(8/50)in the control group,the differences were statistically significant(t=-2.193,P=0.031;χ^2=4.396,P=0.036).Conclusion The subcutaneous drainage tube with continuous irrigation and vacuum suction after stoma reversal can gain high application value,effectively reducing surgical site infection rates and hospital stay in patients with stoma after colorectal cancer operation.

关 键 词：肠造口术 负压伤口疗法 引流术 伤口感染 

分 类 号：R735.34[医药卫生—肿瘤]