注射器负压引流与负压引流瓶临床应用感染风险分析

Clinical Application of Negative Pressure Drainage Vessel and Negative Pressure Drainage of Injector:Risk Factors for Infection

目的探索扩张器置入术后留置注射器负压引流与负压引流瓶的感染关系。方法对17例有>2处手术区域需要置入扩张器,术后留置引流管的患者进行研究;对于同一患者,两处术区一处应用注射负压引流,另一处应用负压引流瓶,在手术后2、4、6 d以及拔管时在引流管自切口引出处皮肤、切口处引流管和引流管末端分别取样,送细菌培养。结果注射器负压引流组与负压引流瓶组送检细菌培养标本各51例,阳性率分别为9.80%和5.88%,差异无统计学意义;不同时间组引流管不同部位的细菌检出率:在4 d组,引流管自切口引出处皮肤有细菌检出,占9.09%,6 d组,引流管自切口引出处皮肤和引流管末端的细菌检出率均为33.33%,不同时间组细菌检出率比较,差异有统计学意义(P<0.05)。结论术后早期注射器负压引流与负压引流瓶相比,注射器负压引流更易引起引流管感染;留置负压引流时间过长,注射器负压引流及负压引流瓶均容易引起感染。

OBJECTIVE To study the risk factors of the infection in the patients with soft tissue expander postoperatively,such as negative pressure drainage vessel and drop stitch.METHODS Totally 17 case of consecutive patients who underwent the soft tissue expander involving at least two sites and set negative pressure drainage tube were studied.For each patient with drainages at two sites,one was negative pressure drainage vessel,the other was drop stitch.The sample were taken from the skin out of the drainage tube,the drainage tube out of skin and the end of drainage after 2,4,6 days of the operation and at the time of removing the tube.Total sample were tested for bacteriology.RESULTS The sample were divided into two groups with 51 cases of specimens for bacterial culture in each group.The positive rates were 2.94% and 1.76%,respectively.The isolation rate of the bacteria from the incision of drainage catheter in 4 d group was 9.09%,and all of the detection rates in 6 d group were 33.33% The positive rate of the pathogens was closely related to the 3 different sampling time（P0.05）.CONCLUSION At the early stage of post-operation period,drop stitch is much easier to cause the infection.With overlong cluration of negative pressure drainage,both the negative pressure drainage vessel and the drop stitch are easier to cause infection.