皮下持续负压引流对预防胃癌术后切口感染的效果  

Effect of subcutaneous continuous negative pressure drainage on preventing incision infection after radical resection of gastric cancer

作　　者：张小磊 江晓晖[1] 江志伟 王刚[2] 吴金东[1] 李国兴[1] ZHANG Xiao-lei;JIANG Xiao-hui;JIANG Zhi-wei;WANG Gang;WU Jin-dong;LI Guo-xing(Department of Gastrointestinal Surgery,Tumor Hospital Affiliated to Nantong University,Nantong,Jiangsu 226006,China)

机构地区：[1]南通大学附属肿瘤医院胃肠外科,江苏南通226006 [2]江苏省中医院普外科,江苏南京210004

出　　处：《中国临床研究》2023年第2期172-175,181,共5页Chinese Journal of Clinical Research

基　　金：国家自然科学基金(81500417);湖北陈孝平科技发展基金(CXPJJH121001-2021060);江苏省中医药科技发展重点项目(ZD201903);南通市科技计划指导性项目(JCZ20134)。

摘　　要：目的探讨皮下持续负压引流对预防胃癌患者术后感染的效果,为临床工作提供依据。方法回顾性分析南通大学附属肿瘤医院2018年1月至2021年9月行胃癌根治术的177例患者的临床资料,分析比较行皮下持续负压引流组患者(引流组,95例)及常规直接缝合组患者(常规组,82例)的总手术时间、术后住院时间、切口愈合等级及切口感染率。结果引流组的切口愈合程度优于常规组(Z=2.372,P=0.018),切口感染率低于常规组(5.3%vs 15.9%,χ^(2)=5.762,P=0.016),患者术后住院时间短于常规组[(8.9±1.4)d vs(9.8±2.4)d,t=3.096,P=0.002],差异有统计学意义。亚组分析显示伴有糖尿病或肥胖的患者术后,引流组的切口感染率低于常规组,差异有统计学意义(P<0.05)。结论皮下持续负压引流能够有效预防胃癌患者术后切口感染,缩短住院时间,尤其对伴有糖尿病或肥胖的患者有明显优势。Objective To explore the effect of subcutaneous continuous negative pressure drainage on prevention of postoperative infection in patients with gastric cancer,so as to provide guidance for clinical practice.Methods The clinical data of 177 patients who underwent radical gastrectomy from January 2018 to September 2021 in Tumor Hospital Affiliated to Nantong University were analyzed retrospectively.The total operation time,postoperative hospital stay,incision healing grade and incision infection rate of patients in the subcutaneous continuous negative pressure drainage group(drainage group,95 cases)and the conventional direct suture group(conventional group,82 cases)were statistically compared.Results Compared with conventional group,drainage group had better incision healing grade(Z=2.372,P=0.018),lower incision infection rate(5.3%vs 15.9%,χ^(2)=5.762,P=0.016),and shorter postoperative hospital stay[(8.9±1.4)d vs(9.8±2.4)d,t=3.096,P=0.002].Subgroup analysis showed that the wound infection rate in the drainage group was significantly lower than that in the conventional group in patients with diabetes or obesity(P<0.05).Conclusion Subcutaneous continuous negative pressure drainage can prevent postoperative incision infection,shorten hospital stay in gastric cancer patients,especially with diabetes or obesity.

关 键 词：胃癌 皮下持续负压引流 胃癌根治术 糖尿病 肥胖 切口感染 切口愈合 住院时间 

分 类 号：R735.2[医药卫生—肿瘤]