封闭式持续冲洗引流的临床应用

Clinical application of closed continuous irrigation and drainage

摘要:

目的  比较封闭式持续冲洗引流、开放引流和人工皮负压封闭引流术，探讨封闭式持续冲洗引流在治疗术后切口感染中的临床应用价值。方法  选取该院2009年6月-2014年12月收治的术后切口感染患者104例，根据患者年龄、病种及切口类型随机分为3组，A组36例，B组34例，C组34例，依次分别采用封闭式持续冲洗引流、开放引流及人工皮负压封闭引流术，并对引流效果进行比较。结果  在换药次数、愈合时间及住院时间上B、C组与A组之间差异均有统计学意义（P <0.05），在切口细菌培养转阴时间上A、B组之间差异有统计学意义（P <0.05），而A、C组之间差异无统计学意义（P >0.05）。3组降钙素原、白细胞计数及血沉等统计结果，在治疗前B、C组与A组数据差异均无统计学意义（P >0.05），治疗后7 d，A、B组各项数据差异均有统计学意义（P <0.05），治疗后7 d，A、C组各项数据差异均无明显统计学意义（P >0.05）。结论  封闭式持续冲洗引流方法简单易行，可减少患者痛苦，明显促进感染切口的愈合，是值得推荐的治疗术后切口感染的治疗方法。

Abstract:

 Objective To compare closed continuous irrigation and drainage, open drainage and artificial skin vacuum sealing drainage, and to discuss the clinical application value of closed continuous irrigation and drainage in the treatment of postoperative incision infection. Methods 104 cases of patients with postoperative incision infection received and cured in the hospital from June 2009 to December 2014 were selected. They were divided into 3 groups for comparison: Group A (36 cases); Group B (34 cases); Group C (34 cases). And the three groups were followed by closed continuous irrigation and drainage, open drainage and artificial skin vacuum sealing drainage. Results For the frequency of dressing change, healing time and hospital stays, the differences between Group B, Group C and Group A had statistical significance (P ＜ 0.05); for the clearance time of incision bacterial culture, the differences between Group A and Group B had statistical significance (P ＜ 0.05), while the differences between Group A and Group C had no obvious statistical significance (P ＞ 0.05). For the procalcitonin, white blood cell count, erythrocyte sedimentation rate (ESR) and other statistical results of the three groups, the data differences between Group B, Group C and Group A had no obvious statistical significance (P ＞ 0.05) before the treatment, while the differences of the data between Group A and Group B had statistical significance (P ＜ 0.05) in 7 days after the treatment and the differences of the data between Group A and Group C had no obvious statistical significance (P ＞ 0.05) in 7 days after the treatment. Conclusion The method of closed continuous irrigation and drainage is simple and practicable, and can reduce the pain of the patients and obviously promote the healing of infected incision, which is the recommendable method for treating postoperative incision infection.