皮下负压引流在结直肠穿孔手术切口缝合中应用效果及术后切口感染的影响因素分析  

作　　者：李国军 咸高峰 宋斌 龚飞虎 

机构地区：[1]浙江省绍兴市上虞人民医院,312300

出　　处：《浙江临床医学》2024年第8期1215-1217,共3页Zhejiang Clinical Medical Journal

摘　　要：目的探讨皮下负压引流在结直肠穿孔手术切口缝合中应用效果,并分析术后发生切口感染的影响因素。方法选取2018年1月至2023年1月收治的结直肠穿孔患者80例,采用随机数字表法分为对照组和观察组,每组各40例。对照组采用常规缝合,观察组在对照组基础上加用皮下负压引流。比较两组临床指标、愈合情况、血清指标及切口感染率,分析影响患者术后发生切口感染的相关因素。结果两组皮肤缝合时间、切口愈合时间、切口愈合率及住院时间比较,差异有统计学意义(P<0.05);术后3 d,两组IL-6、IL-10及hs-CRP水平、切口感染发生率比较,差异有统计学意义(P<0.05);Logistic回归分析年龄较大、患有糖尿病及采用常规缝合治疗为患者术后发生切口感染的独立影响因素。结论采用皮下负压引流可促进结直肠穿孔患者术后恢复,利于降低切口感染率。年龄较大、患有糖尿病及采用常规缝合将增加患者发生术后切口感染风险,故应针对实际情况进行针对干预,以期改善患者预后。Objective To investigate the effect of subcutaneous negative pressure drainage in incision suture in colorectal perforation surgery,and to analyze the factors affecting the occurrence of incision infection after surgery.Methods 80 cases of patients with colorectal perforation admitted from January 2018 to January 2023 were selected and divided into the control group and the observation group using the random number table method,with 40 cases in each group.The control group used conventional suture measures,and the observation group added subcutaneous negative pressure drainage on the basis of the control group.Compare the clinical indexes,healing condition,serum indexes and incision infection rate of the two groups,and analyse the relevant factors affecting the patients'occurrence of postoperative incision infection.Results Comparison of skin suture time,incision healing time,incision healing rate and hospital stay between the two groups showed statistically significant differences(P<0.05).At 3 d postoperatively,comparison of IL-6,IL-10 and hs-CRP levels and incision infection incidence between the two groups showed statistically significant differences(P<0.05).Logistics regression analysis of the older age,suffering from diabetes mellitus and the use of conventional Suture treatment as independent influencing factors for the occurrence of incision infection in patients after surgery.Conclusion The use of subcutaneous negative pressure drainage can promote the postoperative recovery of patients with colorectal perforation and help reduce the incision infection rate,and older age,diabetes mellitus and the use of conventional suture will increase the risk of postoperative incision infection in patients,so we should carry out specific interventions according to the actual situation,in order to improve the prognosis of patients.

关 键 词：皮下负压引流 结直肠穿孔 切口感染 影响因素 

分 类 号：R656[医药卫生—外科学]