洗必泰醇联合含碘手术薄膜对骨科手术患儿血清sICAM-1、PCT、ESR水平及手术部位感染的影响  

Effects of chlorhexidine alcohol combined with iodine-containing surgical membrane on serum sICAM-1,PCT,ESR levels and surgical site infection in children undergoing orthopedic surgery

作　　者：孙海春[1] 徐三勤 岑茜 赖诗华 SUN Haichun;XU Sanqin;CEN Xi;LAI Shihua(Operating Room,Shenzhen Children’s Hospital,Guangdong,Shenzhen 518000,China)

机构地区：[1]深圳市儿童医院手术室,广东深圳518000

出　　处：《中国医药科学》2022年第3期169-172,共4页China Medicine And Pharmacy

基　　金：广东省深圳市卫生计生系统科研项目(201402054)。

摘　　要：目的探讨洗必泰醇联合含碘手术薄膜对骨科手术患儿血清可溶性细胞间黏附因子-1(sICAM-1)、降钙素原(PCT)以及红细胞沉降率(ESR)水平及手术部位感染(SSI)的影响。方法选取2018年1月至2019年3月在深圳市儿童医院接受骨科手术治疗的患儿150例,采用随机数字表法分为对照组和研究组,每组各75例。两组均给予含碘手术薄膜干预,研究组患儿另给予洗必泰醇溶液手术部位消毒,对照组患儿另给予聚维酮碘溶液手术部位消毒。比较两组患儿术后病原菌检出情况、SSI发生率以及切口创面愈合情况,分析手术前后感染相关指标水平。结果研究组患儿SSI发生率为4.00%,分离病原菌7株,对照组患儿感染发生率为14.67%,分离病原菌20株,研究组SSI发生率显著低于对照组(P<0.05);研究组患儿切口创面愈合评分显著高于对照组,愈合时间、住院时间以及术后3、7 d伤口疼痛视觉模拟(VAS)评分显著低于对照组(P<0.05);两组患儿术前sICAM-1、PCT以及ESR水平差异无统计学意义(P>0.05),术后3 d对照组上述指标水平明显高于术前,研究组ESR水平明显高于术前(P<0.05),其余指标手术前后比较,差异无统计学意义(P>0.05),但研究组术后3 d的sICAM-1、PCT以及ESR水平均低于对照组(P<0.05)。结论相比于聚维酮碘溶液,洗必泰醇溶液联合含碘手术薄膜干预更具优势,可更好地杀灭病原菌,降低sICAM-1、PCT以及ESR水平,预防SSI的发生,利于伤口愈合。Objective To investigate the effects of chlorhexidine alcohol combined with iodine-containing surgical membrane on the levels of serum soluble intercellular adhesion molecules-1(sICAM-1),procalcitonin(PCT),erythrocyte sedimentation rate(ESR),and surgical site infection(SSI)in children undergoing orthopedic surgery.Methods A total of 150 children who underwent orthopedic surgery at Shenzhen Children’s Hospital from January 2018 to March 2019 were selected and divided into the control group and the study group by the random number table method,with 75 cases in each group.Both groups were intervened with iodine-containing surgical membrane,where children in the study group were additionally given chlorhexidine alcohol solution for surgical site disinfection,and children in the control group were additionally given povidone-iodine solution for surgical site disinfection.The detection of pathogenic bacteria after surgery,incidence of surgical site infection(SSI)and incision healing were compared between the two groups,and the levels of infection-related indexes before and after surgery were analyzed.Results The incidence of SSI in the study group was 4.00%,with 7 isolated pathogenic bacteria,while the incidence of SSI in the control group was 14.67%,with 20 isolated pathogenic bacteria,and the incidence of SSI in the study group was significantly lower than that in the control group(P<0.05).The incision healing score in the study group was significantly higher than that in the control group,and the healing time,length of stay,and the score of Visual Analogue Scale(VAS)of wound pain at 3 d and 7 d after surgery were significantly lower than those in the control group(P<0.05).Before surgery,there were no statistically significant differences in the levels of sICAM-1,PCT,and ESR between the two groups(P>0.05).At 3 d after surgery,all the levels of the above-mentioned indexes in the control group were significantly higher than those before surgery,and the ESR level in the study group was significantly higher than that b

关 键 词：洗必泰醇 聚维酮碘 含碘手术薄膜 骨科手术 病原菌检出 

分 类 号：R726.1[医药卫生—儿科]