负压封闭引流在急腹症术后手术部位感染中的应用  

Application of Vacuum Sealing Drainage in Surgical Site Infection after Acute Abdominal Surgery

作　　者：欧阳堃 唐城[1] 张辉 熊凌强 OUYANG Kun;TANG Cheng;ZHANG Hui;XIONG Ling-qiang(Department of General Surgery,the First Affiliated Hospital of Nanchang University,Nanchang 330006,China)

机构地区：[1]南昌大学第一附属医院普外科,南昌330006

出　　处：《实用临床医学（江西）》2023年第2期34-37,共4页Practical Clinical Medicine

摘　　要：目的探究负压封闭引流(vacuum sealing drainage,VSD)在急腹症患者术后手术部位感染(surgical site infection,SSI)中的应用价值及疗效。方法选取2021年7月至2022年6月收治的83例急腹症术后发生SSI的患者为研究对象,按SSI处理方式的不同将其分为观察组(n=44)和对照组(n=39)。观察组予切口清创+VSD治疗,对照组予切口清创+常规换药治疗。比较2组患者治疗效果和炎症指标。结果观察组创面Ⅱ期清创缝合处理时间(5.91±1.33)d、住院时间(15.00±5.44)d、换药次数(2.98±1.39)次,分别低于对照组的(11.95±2.89)d、(20.31±7.74)d、(6.67±2.57)次,2组比较差异有统计学意义(P<0.05)。治疗后第7天:2组血清炎症指标水平均低于治疗前;观察组白细胞计数(7.78±2.31)×10^(9)L^(-1)、中性粒细胞百分比(73.10±7.57)%、C反应蛋白(19.18±10.71)mg·L-1分别低于对照组的(10.46±2.28)×10^(9)L^(-1)、(79.65±3.87)%、(40.40±16.57)mg·L^(-1),2组比较差异有统计学意义(P<0.05)。结论急腹症患者术后发生SSI予VSD治疗能有效缩短创面Ⅱ期清创缝合处理时间及患者住院时间,改善患者血清炎症指标,缩短切口愈合时间,减少切口换药次数。Objective To investigate the value and efficacy of vacuum sealing drainage(VSD)in surgical site infection(SSI)after acute abdominal surgery.Methods On the basis of debridement,83 patients with SSI after acute abdominal surgery admitted to our hospital from July 2021 to June 2022 were treated with either VSD(observation group,n=44)or routine dressing change(control group,n=39).Therapeutic effect and inflammatory indexes were compared between the two groups.Results The time of stage II debridement and suture and the length of hospital stay in the observation group((5.91±1.33)and(15.00±5.44)days,respectively)were shorter than those in the control group((11.95±2.89)and(20.31±7.74)days,respectively)(P<0.05).Furthermore,dressing change frequency in the observation group(2.98±1.39)was lower than that in the control group(6.67±2.57)(P<0.05).The levels of serum inflammatory indicators on day 7 after treatment were lower than those before treatment in both groups.Moreover,white blood cell count,neutrophil percentage and C-reactive protein level in the observation group(7.78±2.31)×10^(9)L^(-1),(73.10±7.57)%and(19.18±10.71)mg·L^(-1),respectively)were lower than those in the control group(10.46±2.28)×10^(9)L^(-1),(79.65±3.87)%and(40.40±16.57)mg·L^(-1),respectively)(P<0.05).Conclusion The treatment with VSD can effectively shorten stageⅡdebridement and suture time,hospital stay and incision healing time,improve serum inflammatory indexes,and reduce dressing change frequency in patients with SSI after acute abdominal surgery.

关 键 词：急腹症 手术部位感染 负压封闭引流 

分 类 号：R656.1[医药卫生—急诊医学]