改良式封闭式负压吸引在手术后消化道瘘中的临床应用

Clinical application of modified closed negative pressure suction in the postoperative digestive tract fistula

目的探讨改良式封闭式负压吸引在手术后消化道瘘中的应用效果。方法选择2014年5月-2016年4月本科室收治的消化道瘘患者50例,并随机分为甲、乙两组,每组均包含25例患者,甲组患者行开放式持续负压引流方案,乙组患者行改良式封闭式负压吸引,对临床指标与瘘口相关指标、瘘口周边皮肤指标及术后舒适度情况进行比较。结果乙组患者住院天数、痊愈天数、渗出液体积、术后换药次数、吻合口狭窄例数、再次手术率、引流管周边皮肤感染例数、创口感染例数、敷料与衣服污染例数均低于甲组,而在活动能力、情绪、睡眠质量、疼痛感及社会参与感评分方面则均高于甲组,两组差异有统计学意义（P〈0.05）。结论改良式封闭式负压吸引用于治疗消化道瘘,能够缩短住院天数,减轻家庭经济压力,降低术后感染率与再次手术率,且能改善生活舒适度,值得进一步推广。

Objective To explore the application effect of modified closed negative pressure suction in the postoperative digestive tract fistula. Methods 50 cases of patients with digestive tract fistula cured in our hospital from May 2014 to April 2016 were selected and randomly divided into group A and group B with 25 cases in each. Patients in group A were treated with open continuous negative pressure drainage,and patients in group B were treated with modified closed negative pressure suction.Clinical index and the index of the fistula,the surrounding skin index and the postoperative comfort level of the two groups were compared. Results Length of hospital stay,number of days of healing,volume of exudates,number of dressing changes,stenosis of anastomotic stoma,reoperation rate,drainage tube surrounding the skin infection cases,wound infection cases, and the number of cases of contaminated clothes dressing of group B were lower than those of group A.Activity ability,mood,sleep quality,pain perception and social participation score of group B were higher than those of group A.There was statistical significance of the difference between the two groups（P〈0.05）. Conclusion Modified closed negative pressure suction in the postoperative digestive tract fistula can shorten the length of stay in hospital,reduce the family economic pressure,low postoperative infection rate and reoperation rate,and improve the living comfort.It is worthy of further promotion.