骨科创腔血性液引流袋更换频率与手术切口感染的相关性研究

Study on correlation between frequency of replacement of invasive cavity bloody fluid drainage bag and operative incision infection in department of orthopedics

[目的]探讨骨科创腔一次性血性液引流袋更换频率与手术切口感染的相关性,以降低医源性导管相关性切口感染几率。[方法]将120例术后置创腔引流管并接一次性血性液引流袋的非感染性骨科手术病人随机分为对照组39例、观察1组40例、观察2组41例。3组病人均于术后每24h计量后排空引流袋,对照组常规24h更换1次创腔引流袋,观察1组48h更换1次创腔引流袋,观察2组则不更换引流袋,仅于每24h计量后排空引流袋即可。对照组、观察1组分别于更换引流袋时取其橡皮引流管外口内侧、引流袋内引流液标本送检一般细菌培养;观察1组、观察2组每24h计量后排空创腔引流袋并采集引流袋内残留液体标本送检一般细菌培养。比较3组各部位一般细菌培养阳性率、病人术后体温变化及术后切口感染率。[结果]3组病人术后3d^7d体温变化比较差异无统计学意义(P>0.05)。3组病人术后48h至术后7d切口感染率比较差异有统计学意义(P<0.05)。3组病人术后24h引流袋内液及手术切口一般细菌培养结果均为阴性;3组术后48h、术后72h引流袋内液及手术切口一般细菌培养阳性率比较差异均有统计学意义(P<0.05)。[结论]对于骨科手术病人术后一次性创腔血性液引流袋的护理,只需于术后每24h计量后排空创腔引流袋即可,不必24h或48h更换1次创腔血性液引流袋,并不会增加创腔血性引流袋细菌滋生及医源性导管相关性切口感染几率。

Objective:To probe into the correlation between the frequency of replacement of disposable invasive cavity bloody liquid drainage bag and operative incision infection in department of orthopedics,in order to reduce the risk of iatrogenic catheter-related incision infection.Methods:A total of 120 cases of noninfectious orthopedic surgery patients with postoperative invasive cavity drainage tube and setting disposable bloody liquid drainage bag were randomly divided into control group with 39 cases,observation group one with 40 cases,observation group two with 41 cases.The drainage bags were emptied in the 3groups of patients after every 24 h metering after surgery.The drainage bag was replaced every 24 hin control group,the drainage bag was replaced every 48 hin observation group one,the drainage bag wasn't replaced in observation group two and were only emptying the drainage bag at every 24 hafter metering.The fluid specimens respective inside outer port of rubber drainage tube and drainage bag were taken for general bacterial culture in control group and observation group one;the residual liquid in the invasive cavity drainage bag was taken after emptying at every 24 hafter metering for general bacterial culture respectively in observation group one and observation group two.The positive rate of bacterial culture,the postoperative body temperature change of the patients and the rate of incision infection were compared among the three groups.Results:There was no statistically significant difference in body temperature from postoperative 3dto 7damong the three groups(P>0.05).There was statistically significant difference in the rate of incision infection from postoperative 48 hto 7damong the three groups(P<0.05).There were statistically significant differences in the positive rate of bacterial culture at postoperative 48hand72 hamong the three groups(P<0.05).Conclusion:For postoperative care of patients with disposable invasive cavity bloody liquid drainage bag in department of orthopedics,they only needed to empty the drainage bag after every 24 hmetering.It didn't need to replace the drainage bag every 24 hor 48hand it the risk of bacteria breeding and iatrogenic catheter related incision infection didn't increase in invasive cavity bloody fluid drainage bag.