初次人工髋关节置换术后早期引流管夹闭时间对引流量影响的护理

目的观察人工髋关节置换术后早期引流管夹闭时间对引流量的影响。方法随机将118例初次人工髋关节置换术患者分为对照组、实验1组和实验2组。对照组按传统方法正常负压保持引流通畅;实验1组手术完毕缝皮后即夹闭引流管,至术后4h后持续开放;实验2组手术完毕缝皮后即关闭引流管,至术后6h后持续开放;观察各组术后8、12、24h的切口引流量,引流管关节腔内末端细菌培养情况,切口愈合时间,出院时髋关节功能评分。结果术后8、12、24h的切口引流量各组间比较,差异有统计学意义(P<0.05),对照组的引流量明显多于实验1组和实验2组,实验2组最少,切口愈合时间、出院时关节功能评分及引流管顶端细菌培养各组间比较,差异无统计学意义(P>0.05)。结论髋关节置换术后6h内暂时夹闭引流管能减少切口引流量,且对切口的愈合情况及关节功能的恢复无不良影响。

Objective To observe the effect of drainage pipe clamp time on the drainage rate after primary hip join replacement.Methods According to the order of patient＇s admission to the hospital,118 cases of first time hip join replacement patients were divided into control group,experimental groupⅠ,and experimental group Ⅱ.In the control group,keeping normal pressure and drainage was kept flowing clearly by the traditional methods;In experimental group Ⅰ,the drainage pipe was clipped at once after operation,and it was lift continually in 4 hours after operation;In experimental group Ⅱ,the drainage pipe was clipped at once after operation,and it was lift continually in 6 hours after operation;Observing the drainage rates of incision in each group in 8 hours,12 hours and 24 hours,the germiculture of drainage tube joint cavity tip,the wound healing time,and the functional score of hip joint while leaving hospital.Results There was significant difference（P0.05）,compared every group on postoperative incision flow rate in 8,12 and 24 hours.The drainage volume in control group was more obviously than the experimental groupⅠand the experimental group Ⅱ.The experimental group Ⅱ was the least.There was no difference（P0.05） between every group in terms of the wound healing time,hospital joint function score,and bacterial culture in the top of the drainage tube.Conclusion A temporary clamping of the drainage tube can reduce incision drainage in 6 hours after hip replacement,and there was no adverse effect on the incision healing and joint function recovery.