清热消痈止痛方贴敷联合光子疗法对剖宫产术后切口感染的疗效分析  

Analysis of the therapeutic effect of the combination of Qingre Xiaoyong Zhitong Recipe and photon therapy in the incision infection after cesarean section

作　　者：刘宏 田颖 杨彩慧 胡丽梅 Liu Hong;Tian Ying;Yang Caihui;Hu Limei(Birthing Center,Zhangjiakou Maternal and Child Health Hospital,Zhangjiakou Hebei 075000,P.R.China;Department of Obstetrics and Gynecology,Zhangjiakou Maternal and Child Health Hospital,Zhangjiakou Hebei 075000,P.R.China)

机构地区：[1]张家口市妇幼保健院分娩中心,河北张家口075000 [2]张家口市妇幼保健院妇产科,河北张家口075000

出　　处：《中国计划生育和妇产科》2024年第5期61-66,78,共7页Chinese Journal of Family Planning & Gynecotokology

基　　金：张家口市重点研发计划项目(项目编号:2221101D)。

摘　　要：目的分析清热消痈止痛方贴敷联合光子治疗对剖宫产术后切口感染患者可溶性髓样细胞触发受体1(sTREM-1)、白介素-1(IL-1)、白介素-8(IL-8)表达的影响。方法选取2021年6月至2023年6月在张家口市妇幼保健院就诊的剖宫产术后切口感染患者作为研究对象,使用光子治疗仪治疗作为光子治疗组、使用清热消痈止痛方贴敷治疗作为贴敷组、使用清热消痈止痛方贴敷联合光子治疗仪治疗作为联合组,各50例。比较3组患者切口疼痛、宫颈微循环状态(宫颈局部血管清晰占比、毛细血管管径、微血管管径、血流灌注)、免疫应激指标[皮质醇(Cor)、CD4^(+)T淋巴细胞、CD8^(+)T淋巴细胞比例]、血清sTREM-1、IL-1、IL-8表达水平,并统计切口愈合情况及治疗效果。结果与光子治疗组比较,联合组、贴敷组切口疼痛评分降低,宫颈局部血管清晰占比、毛细血管管径、微血管管径、血流灌注、CD4^(+)T淋巴细胞升高,Cor、CD8^(+)T淋巴细胞、血清sTREM-1、IL-1、IL-8表达水平降低,愈合时间缩短(P<0.05)。与贴敷组比较,联合组切口疼痛评分降低,宫颈局部血管清晰占比、毛细血管管径、微血管管径、血流灌注、CD4^(+)T淋巴细胞升高,Cor、CD8^(+)T淋巴细胞、血清sTREM-1、IL-1、IL-8表达水平降低,愈合时间缩短(P<0.05)。与光子治疗组比较,联合组、贴敷组切口总愈合率、总有效率升高(P<0.05),与贴敷组比较,联合组切口总愈合率、总有效率升高(P<0.05)。结论清热消痈止痛方贴敷联合光子治疗可改善剖宫产术后切口感染患者宫颈微循环、免疫应激异常,抑制sTREM-1、IL-1、IL-8合成,从而促进切口愈合,减轻疼痛,消除感染症状,效果理想。Objective To analyze the effect of Qingre Xiaoyong Zhitong Recipe application combined with photon therapy on the expression of soluble myeloid cell trigger receptor-1(sTREM-1),interleukin-1(IL-1)and interleukin-8(IL-8)in patients with wound infection after caesarean section.Methods Patients with incision infection after cesarean section who received treatment at Zhangjiakou Maternal and Child Health Hospital from June 2021 to June 2023 were selected as the research subjects.The photon therapy was used as the photon therapy group,the Qingre Xiaoyong Zhitong Recipe was used as the patch group,and the application of Qingre Xiaoyong Zhitong Recipe combined with photon therapy was used as the combination group,50 cases in each group.Compared the incision pain,cervical microcirculation status(proportion of clear cervical blood vessels,capillary diameter,microvascular diameter,blood flow perfusion),immune stress indicators[cortisol(Cor),CD4^(+)T lymphocytes,CD8^(+)T lymphocyte ratio],and serum levels of sTREM-1,IL-1,and IL-8 expression in three groups of patients,and analyzed the wound healing and treatment effectiveness.Results Compared with the photon therapy group,the incision pain score in the combination group and the patch group was reduced,the proportion of clear cervical local blood vessels,capillary diameter,microvascular diameter,blood perfusion,CD4^(+)T lymphocytes were increased,and the expression levels of Cor,CD8^(+)T lymphocytes,serum sTREM-1,IL-1 and IL-8 were decreased,and the healing time was shortened(P<0.05).Compared with the patch group,the incision pain score of the combination group was decreased,the proportion of clear cervical local blood vessels,capillary diameter,microvascular diameter,blood perfusion,CD4^(+)T lymphocytes were increased,the expression levels of Cor,CD8^(+)T lymphocytes,serum sTREM-1,IL-1,IL-8 were decreased,and the healing time was shortened(P<0.05).Compared with the photon therapy group,the total wound healing rate and total effective rate of the combination group and the pa

关 键 词：清热消痈止痛方贴敷 光子治疗 剖宫产术后切口感染 可溶性髓样细胞触发受体1 白介素-1 白介素-8 

分 类 号：R719.8[医药卫生—妇产科学] R619.3[医药卫生—临床医学]