负压封闭引流技术在降低肠造口还纳术后切口感染中的作用  

Study on the Effect of Vacuum Sealing Drainage on the Reduction of Incision Infection after Ileostomy Closure

作　　者：朱慧新[1,2] 郑建涛[3] ZHU Huixin;ZHENG Jiantao(Department of Nursing,National Regional Medical Center,Binhai Campus of the First Affiliated Hospital,Fujian Medical University,Fuzhou 350212,China;Department of Nursing,The First Affiliated Hospital,Fujian Medical University,Fuzhou 350005,China;Department of Gastrointestinal Surgery,The First Affiliated Hospital,Fujian Medical University,Fuzhou 350005,China)

机构地区：[1]福建医科大学附属第一医院滨海院区国家区域医疗中心护理部,福州350212 [2]福建医科大学附属第一医院护理部,福州350005 [3]福建医科大学附属第一医院胃肠外科,福州350005

出　　处：《福建医科大学学报》2023年第3期189-193,共5页Journal of Fujian Medical University

基　　金：福建省自然科学基金项目(2020J01977)。

摘　　要：目的评估负压封闭引流技术(VSD)在预防回肠造口还纳术后切口感染中的作用。方法回顾性分析2017年6月—2021年6月行回肠造口还纳术患者的临床资料,根据切口是否预留VSD装置分为VSD组和对照组,对年龄、性别、美国麻醉医师协会分级标准(ASA)、体质量指数(BMI)、术前血清白蛋白和是否合并糖尿病等因素进行1∶1倾向评分匹配(PSM)。比较2组患者术后切口感染率、术后住院时间、术后并发症及住院费用等指标。进一步根据年龄、术前血清白蛋白水平、BMI及是否合并糖尿病进行亚组分析。结果经过PSM后,VSD组和对照组各纳入144例患者,2组患者的临床基线资料比较,差别无统计学意义(P>0.05);对照组和VSD组术后切口感染发生率比较,差别有统计学意义[7.6%(11/144)vs 2.1%(3/144),P=0.028];VSD组的住院费用显著低于对照组[(2.2±0.2)万元vs(2.6±0.4)万元,P=0.043];2组患者的术后住院时间、其他术后并发症比较,差别均无统计学意义(P>0.05)。亚组分析显示,在BMI>28 kg/m 2的亚组中,VSD组的切口感染率明显低于对照组(P<0.05);而在其他亚组分析中,2组患者切口感染率的差别无统计学意义(P>0.05)。结论VSD可降低回肠造口还纳术后切口感染发生率和住院费用,尤其在BMI>28 kg/m 2亚组的患者中具有潜在保护作用。Objective To evaluate the effect of vacuum sealing drainage(VSD)in the prevention of incision infection after ileostomy closure.Methods This retrospective cohort study was conducted at our center from June 2017 to June 2021 to analyze the clinical data from patients undergoing ileostomy closure after 1∶1 propensity score matching(PSM)according to patient characteristics including age,sex,American association of anesthesiologists scores(ASA),body mass index(BMI),albumin and diabetes.Patients were divided into VSD and controlled group according to the usage of VSD.The outcomes were incision infection.Further subgroup analysis was conducted by BMI,preoperative albumin,diabetes and ages.Results One hundred and forty-four patients in VSD group and 144 patients in the control group were included after PSM.Eleven patients in the control group and 3 patients in VSD group were diagnosed with incision infection[7.6%(11/144)vs 2.1%(3/144),P=0.028].The hospitalization costs of VSD group was significantly less than that of the control group[(22±2)thousand yuan vs(26±4)thousand yuan,P=0.043].The between-groups differences of basic line and other outcomes were not significant.Further subgroup analysis indicated that the differences of incision infection rate was significant in the subgroup of BMI>28 kg/m^(2)between VSD group the control group.For the remaining subgroups,there was no evidence of subgroup differences.Conclusions VSD could significantly reduce incision infection rate after ileostomy closure and hospitalization costs,especially in BMI>28 kg/m^(2)subgroup.

关 键 词：负压封闭引流技术 回肠造口还纳术后 切口感染 

分 类 号：R735.34[医药卫生—肿瘤]