改良式负压引流装置应用效果分析

Application and Effect Analysis of Modified Negative Pressure Drainage Device

目的 介绍一种自行改进的可以有效引流腔隙内渗出液的负压引流系统,并同传统引流系统及未经改进的负压引流系统进行对照,比较其引流效能。方法 选取2012年1月至2014年12月行腹部手术、术后入住ICU的患者,按照接受引流方式的不同分为传统引流组（C组）、负压引流组（N组）,其中负压引流组部分患者采用作者自行改进的负压引流器（M组）,比较不同组别患者平均每日引流液量、敷料更换次数、倾倒负压球次数及入住ICU时间。结果 共收集59例满足条件的患者,其中C组23例,N组18例,M组18例,3组患者年龄、性别、入住ICU时间等资料组间比较差异无统计学意义,N组患者每次负压球失去负压时,倾倒引流液经量筒精确测量,容量为（138.46±15.65）m L,相对负压球标定容量200 m L,回收率为（69.2±7.8）%。N组及M组患者倾倒负压球次数组间比较差异无统计学意义[分别为（3.50±3.19）次和（2.53±1.15）次,F=0.835,P=0.413]。3组间平均每日引流液量差异有统计学意义[C组：（75.43±50.86）m L,N组：（82.08±56.91）m L,M组：（131.67±65.15）,F=5.478,P=0.007],更换敷料次数组间比较差异有统计学意义[C组：（1.39±1.03）,N组：（2.11±1.41）次,M组：（0.50±0.71）次,χ^2=15.431,P〈0.001]。结论 改良的负压引流设备在保留了负压引流高效能特点的基础上,避免了不良后果,减少了护理压力,简单易行,适合推广。

Objective To introduce a modified negative pressure drainage device which can effectively dlainage out the exudation of operational cavity, and compare its effectiveness to traditional drainage and negative pressure drainage devices. Methods A prospective study was conducted, proper post-operation patients transferred to intensive care unit from January 2012 to December 2014 were recruited to the study. These patients were divided into three groups based on the different types of drainage ： conservative group （ C group）, negative pressure dininage group （N group） and modified negative pressure drainage group （M group）. In C group, the drainage device was a single drainage bag; in N group, the drainage device was a negative pressure ball connected directly to the drainage tube ; While in M group, the drainage device was a combination of drainage bag and negative bail. The drainage fluid volume, time of surgical dressing change, time of dumping the fluid and ICU staying time were compared among different groups. Results 59 patients were enrolled in the study, including 23 in C group, 18 in N group and 18 in M group. There were no statistical differences of the sex, age and ICU stay time among three groups. The fluid volume of negative ball in N group when lose of negative pressure were 138.46± 15.65 mL, as a rate of （69.2±7.8） % compared to the total volume of 200 mL. There was no statistical difference of the fluid dumping time between N and M group （N group ： 3.50±3.19, M group： 2.53±1.15, F = 0.835, P = 0.413 ）. Statistical differences were found of the average drainage fluid volume （C group ： 75.43±50.86, N group ： 82.08±56.91, M group ： 131.67±65.15, F = 5.478, P = 0.007） and the surgical dressing change time （ C group ： 1.39 ±1.03, N group ： 2.11 ±1.41, M group ： 0.50 ±0.71, χ^2= 15.431, P 〈 0.001 ） among different groups. Conclusion The above mentioned modified negative pressure drainage have the advantages of both conservative drainage and negative pressure drainage, which can avoid negative effects of both and release the care giving, and is proper for expending clinical use.