聚维酮碘稀释液腹腔冲洗在预防坏疽性阑尾炎伴穿孔术后腹腔及切口感染中的作用

Preventive effect on gangrenous perforated appendicitis with postoperative abdominal cavity and incision infection by washing abdominal cavity with povidone iodine diluent

目的探讨聚维酮碘稀释液腹腔冲洗在预防坏疽性阑尾炎伴穿孔术后腹腔及切口感染的临床效果。方法选择我院近年来手术治疗的坏疽性阑尾炎伴穿孔患者为研究对象,术中分别应用聚维酮碘稀释液、甲硝唑和生理盐水对腹腔及切口进行冲洗,对比分析三组患者术后腹腔及切口感染情况、体温恢复正常时间、术后住院时间以及相关不良反应发生情况。结果聚维酮碘组和甲硝唑组腹腔及切口感染发生率比较差异无统计意义(P>0.05),且均明显低于生理盐水组,差异有统计学意义(P<0.05);三组患者体温恢复正常平均时间比较差异无统计学意义(P>0.05);聚维酮碘组和甲硝唑组患者平均住院时间均明显短于生理盐水组(P<0.01),而聚维酮碘组和甲硝唑组比较差异无统计学意义(P>0.05);甲硝唑组术后不良反应发生率高于聚维酮碘组和生理盐水组,但差异均无统计学意义(P>0.05)。结论聚维酮碘稀释液腹腔冲洗能有效降低坏疽性阑尾炎伴穿孔术后腹腔及切口感染发生率,缩短住院时间,且操作简单,不良反应少,值得临床推广应用。

Objective To investigate the clinical effect on gangrenous perforated appendicitis with postoperative abdominal cavity and incision infection by washing abdominal cavity with povidone iodine diluent. Methods Gangrenous perforated appendicitis patients treating with the surgical treatment in our hospital were selected as the research object,they were respectively given povidone iodine diluent,metronidazole and physiological saline for washing abdominal cavity and incision during operation. Comparatively analyzed postoperative abdominal cavity and incision infection status,time of body temperature returned to normal,postoperative hospital stay,and adverse reactions of the three groups. Results The incidence of abdominal cavity and incision infection had no significant difference between the povidone iodine group and metronidazole group（P ＆gt; 0. 05）,and it was significantly lower than the physiological saline group,the difference was significant（P ＆lt; 0. 05）;The body temperature of the three groups returned to normal time had no significant difference（ P ＆gt; 0. 05）;The average time of hospital stay of povidone iodine group and metronidazole group were significantly shorter than that of the physiological saline group（ P ＆lt; 0. 01）,and there was no significant difference between povidone iodine group and metronidazole group（P ＆gt; 0. 05）;The incidence of postoperative adverse reaction of metronidazole group was higher than that of povidone iodine group and physiological saline group,but there was no significant difference（ P ＆gt; 0. 05）. Conclusion Povidone iodine diluent washing abdominal cavity can effectively reduce incidence rate of postoperative abdominal cavity and incision infection of the gangrenous perforated appendicitis,and the operation is simple,it has less adverse reaction,and worth of clinical promotion and application.