中药芒硝外敷防治腹部外科术后手术部位感染的临床疗效研究  

Prevention and treatment of postoperative surgical site infection in abdominal surgery with external application of Chinese medicine mirabilite

作　　者：彭宣福 王德良 王尧 PENG Xuan-fu;WANG De-liang;WANG Yao(General Surgery Department of Mianyang Traditional Chinese Medicine Hospital Sichuan Mianyang(621000),China)

机构地区：[1]四川省绵阳市中医医院普通外科,四川绵阳621000

出　　处：《中国中西医结合外科杂志》2024年第4期471-475,共5页Chinese Journal of Surgery of Integrated Traditional and Western Medicine

基　　金：四川省中医药管理局中医药科研专项课题(2021MS268)。

摘　　要：目的:观察中药芒硝外敷防治腹部外科术后手术部位感染的临床疗效。方法:选取2020年5月—2023年5月我院收治的320例腹部外科手术患者作为研究对象,采用随机数字表法分为对照组与观察组各160例,对照组术后使用常规无菌敷料覆盖切口及术后处理,观察组于术后48 h在对照组常规处理的基础上加用自制中药芒硝封包进行手术区域的持续外敷治疗,观察两组患者术后手术部位感染发生情况、切口愈合情况、炎性指标、随访期内手术部位感染发生情况等指标。结果:观察组术后手术部位感染发生率为6.88%(11例),显著低于对照组的14.38%(23例)(P<0.05)。术后切口愈合等级中,观察组甲级愈合率为95.00%,显著高于对照组的82.50%(P<0.05)。两组患者切口感染类型构成差异无统计学意义(P>0.05),观察组总住院时间、住院期间换药费用、住院期间总费用均低于对照组,差异有统计学意义(P<0.05)。术后1周,观察组白细胞(WBC)、C-反应蛋白(CRP)、降钙素原(PCT)、白细胞介素-6(IL-6)水平显著低于对照组(P<0.05)。随访期内,两组手术部位感染发生率无统计学差异(P>0.05)。结论:芒硝外敷可显著减少腹部外科手术患者术后手术部位感染风险,降低患者炎症反应,缩短患者住院时间,减少住院费用,节约医疗资源,且本法取材方便、价格低廉、使用简单、无明显不良反应,有较好的应用价值,值得临床推广。Objective To observe the clinical efficacy of external application of Chinese medicine mirabilite in the prevention and treatment of postoperative infection at the surgical site of abdominal surgery.Methods 160 patients with abdominal surgery admitted from June 2021 to June 2023 were selected as the study subjects and randomly divided into a control group and an observation group.The control group received routine sterile dressing to cover the incision and postoperative treatment.The observation group received continuous external application of self-made Chinese medicine mirabilite packaging on the surgical area within 48 hours after surgery,in addition to routine treatment in the control group.The incidence of postoperative infection at the surgical site was observed in both groups of patients Indicators such as wound healing,inflammatory indicators,and incidence of surgical site infections during the follow-up period.Results The incidence rate of postoperative surgical site infection in the observation group was 6.88%(11 cases),significantly lower than 14.38%(23 cases)in the control group(P<0.05).In the postoperative incision healing level,the observation group had a grade A healing rate of 95%,significantly higher than the control group's 85%(P<0.05).There was no statistically significant difference in the composition of incision infection types between the two groups of patients(P>0.05).The total hospitalization time,dressing change cost during hospitalization,and total hospitalization cost in the observation group were lower than those in the control group,and the difference was statistically significant(P<0.05).One week after surgery,the levels of WBC,CRP,PCT,and IL-6 in the observation group were significantly lower than those in the control group(P<0.05).During the follow-up period,the incidence of surgical site infection in the observation group was lower than that in the control group, but there was no statistical difference (P >0.05). Conclusion The use of mirabilite external application can significan

关 键 词：芒硝外敷 腹部外科手术 手术部位感染 

分 类 号：R656[医药卫生—外科学] R269[医药卫生—临床医学]