加压涡流冲洗加扩大无菌覆盖面预防外科手术切口感染临床研究

Clinical research on effect of pressurized eddy current douche plus expanding aseptic covering surface on prevention of surgical incision infections

目的探讨加压涡流冲洗加扩大无菌覆盖面,以促进手术切口愈合并降低手术切口感染率。方法选择2013年1月-2014年4月外科择期及急诊手术患者600例为研究对象,按入院单双月顺序分为对照组304例和观察组296例,观察组患者术毕关闭腹膜后采用37℃生理盐水加压涡流式冲洗手术切口,对照组患者则采用传统手术室等温的生理盐水边冲边擦洗手术切口,观察比较两组患者术后切口甲级愈合率、感染发生率、切口愈合时间、换药次数、换药时间及费用等。结果两组比较,切口甲级愈合率观察组为98.31%,对照组为95.07%;感染率观察组为1.69%明显低于对照组的4.93%;切口愈合时间、换药次数、换药时间及换药费用明显少于对照组,两组比较差异均有统计学意义(P<0.05)。结论采用37℃生理盐水加压涡流冲洗加扩大无菌覆盖面能促进切口愈合,缩短愈合时间,降低手术切口感染率,减轻患者术后痛苦和经济负担,且方法简单,易推广应用。

OBJECTIVE To explore the effect of pressurized eddy current douche plus expanding aseptic covering surface on promotion of healing of surgical incision and reduction of incidence of surgical incision infections . METHODS A total of 600 patients who underwent the elective surgeries and emergency surgeries from Jan 2013 to Apr 2014 were recruited as the study objects and were divided into the control group with 304 cases and the obser‐vation group with 296 cases according to the odd and even month to admit to the hospital ;the observation group was treated with 37℃ normal saline pressurized eddy current douche for surgical incision after the peritoneal su‐ture ,and the control group was given the conventional isothermal saline to douche the surgical incision ;the class‐A healing rate of incisions ,incidence of infections ,time of incision healing ,frequency of drug dressing ,dressing time ,and cost were observed and compared between the two groups .RESULTS As compared with the two groups , the class‐A healing rate of incision was 98 .31% in the observation group ,95 .07% in the control group ;the inci‐dence of infections was 1 .69% in the observation group ,significantly lower than 4 .93% in the control group ;the time of incision healing ,frequency of dressing ,drug dressing time ,and dressing cost of the observation group were significantly less than those of the control group ,there were statistically significant differences between the two groups （P〈0 .05） .CONCLUSION The 37℃ normal saline pressurized eddy current douche plus expanding a‐septic covering surface can promote the incision healing ,shorten the healing time ,reduce the incidence of surgical incision infections ,and alleviate the postoperative suffering as well as economic burden ;it is simple and worthy to be promoted .