自制简易负压吸引在直肠癌腹会阴联合根治术后会阴部切口换药中的应用  

Application of self-made simple negative pressure suction in perineal incision after Miles operation for rectal cancer

作　　者：纪建波[1] 郑伟[1] 罗丹丹[1] JI Jianbo;ZHENG Wei;LUO Dandan(Department of Gastrointestinal Surgery,the First People's Hospital of Qinzhou,Qinzhou,The Guangxi Zhuang Autonomous Region 535000,China)

机构地区：[1]钦州市第一人民医院胃肠外科,广西壮族自治区钦州535000

出　　处：《安徽医药》2023年第7期1356-1358,共3页Anhui Medical and Pharmaceutical Journal

基　　金：广西壮族自治区临床重点专科建设项目(桂卫医发[2022]17号);广西壮族自治区卫健委自筹科研课题(20210303)。

摘　　要：目的探究简易负压吸引对于直肠癌腹会阴联合根治术(Miles术)后会阴部切口的应用。方法选取钦州市第一人民医院2021年6—12月收治的低位直肠癌病人60例,采用随机数字表法分为观察组和对照组各30例。观察组采用简易负压吸引装置进行换药治疗,对照组采用普通灭菌敷料换药治疗。比较两组病人愈合时间、换药时疼痛程度、换药次数、切口感染率及病人满意度等,以及手术后第1、3、5天视觉模拟评分法(VAS)得分。结果与对照组比较,观察组切口感染率(0.00%比20.0%)、换药次数[(3.73±0.74)次比(12.07±2.26)次]、切口愈合天数[(8.53±1.33)d比(13.73±1.74)d]均明显降低,差异有统计学意义(P<0.05)。与对照组比较,观察组术后第3天[(3.23±1.01)分比(4.77±0.77)分]、第5天[(2.23±1.01)分比(3.99±0.87)分]VAS评分均明显降低(P<0.05)。病人术后康复体验的满意度,观察组为96.55%,远高于对照组的73.08%(P<0.05)。结论在低位直肠癌Miles术后会阴部切口的研究中,与传统换药方式相比,简易负压吸引不仅可以降低会阴部切口的感染率、还可以减少会阴部切口的换药次数,加速切口的愈合,减轻病人的切口疼痛,提高病人的满意度,从而达到缩短住院时间的目的,改善病人术后康复的体验,值得临床推广使用。Objective To explore the application of self-made of simple negative pressure suction for perineal incision after Miles surgery for rectal cancer.Methods A total of 60 patients with low rectal cancer admitted to the First People's Hospital of Qinzhou from June to December 2021 were randomly divided into experimental group and control group,with 30 cases in each group.The experimental group was treated with self-made simple negative pressure suction device,while the control group was treated with ordinary sterilized dressing.The healing time,pain degree at dressing change,times of dressing change,incision infection rate and patient satisfaction were compared between the two groups,and the pain score of Visual Analogue Scale(VAS)at 1 day,3 days and 5 days after operation was compared between the two groups.Results Comparison between the experimental group and the control group:The wound infection rate(0.00%vs.20.0%),dressing change times(3.73±0.74 vs.12.07±2.26)and wound healing days(8.53±1.33 vs.13.73±1.74)were significantly decreased(P<0.05).The VAS score of postoperative pain in the experimental group was significantly lower than that in the control group on the 3rd day(3.23±1.01 vs.4.77±0.77)and the 5th day(2.23±1.01 vs.3.99±0.87,P<0.05).The satisfaction of patients'postoperative rehabilitation experience was 96.55% in the experimental group,which was much higher than 73.08% in the control group(P<0.05).Conclusion In the care of Miles perineal incision postoperative rectal cancer,compared with the traditional way of dressing,homemade improvised pressure suction not only reduce the perineal incision infection,but also reduce the switching frequency of the perineum incision,accelerate the healing of incision,relieve patients with incision pain,improve patient's satisfaction,so as to achieve the aim of shortening the length of time,to improve the postoperative rehabilitation experience of patients,it is worthy of clinical application.

关 键 词：负压伤口疗法 换药术 直肠癌腹会阴联合根治术 术后切口愈合 直肠肿瘤 

分 类 号：R735.37[医药卫生—肿瘤]