髋膝关节置换术后一次性创腔血性液引流袋更换频率的临床研究

Clinical study on replacement frequency of disposable gen cavity hemorrhagic fluid drainage bag after hip knee arthroplasty

目的:探讨髋膝关节置换术后一次性创腔引流袋更换频率与手术切口感染的相关性,以减少医源性导管相关性切口感染几率。方法:选择80例术后置创腔引流管并接一次性血性液引流袋的髋膝关节置换术患者,随机分为对照组A和观察组B、C。A组24 h更换1次引流袋,B组48h更换一次,C组不更换直至拔管。分别留取引流管、引流袋内液体及手术切口分泌物送检细菌培养。观察各组各部位细菌培养阳性结果及术后切口感染率。结果:术后24 h,A、B、C组细菌培养结果均为阴性,差异无统计学意义(P>0.05)。术后48 h,A组各部位细菌培养阳性结果均为3例,阳性率11.53%,B组均为2例,阳性率7.40%,C组阴性,χ~2值=3.103,P<0.05,差异有统计学意义。术后72 h,A组各部位细菌培养阳性结果均为5例,阳性率19.23%,B组均为3例,阳性率11.11%,C组阴性,χ~2值=5.499,P<0.05,差异有统计学意义。3组患者术后切口感染率比较:术后第2天,χ~2值=3.103,P<0.05;术后第3至7天,χ~2值=4.211,P<0.05,差异均有统计学意义。结论:对于髋膝关节置换术后一次性创腔引流袋的护理,直接于每24 h计量后排空引流袋至拔管即可,不必常规每24 h或48 h更换1次创腔引流袋,可显著降低或杜绝医源性导管相关性切口感染几率。

Objective：Explore the correlation between the replacement frequency of Disposable liquid drainage bag undergoing total hip or knee joint artbroplasty with the infection of operative incision to reduce incision infection rate by iatrogenic catheter. Methods：A total of 24 patients subjected to disposable liquid drainage bag after total hip or knee joint arthroplasty were assigned to 3 groups randomly： control group （A） and trial group （B,C）. The replacing frequency of drainage pack in group A,B and C was 24 hours,48 hours and never respectively. Liquid from drainage tube, drainage bag and surgical incision secretion were taken for bacterial culture. The results of bacterial culture and postoperative incision infection rate were compared. Results：24 hours after operation,there was no significant difference in three groups of specimens which were cultured by bacterical. 48 hours after operation,there were 3 cases and 2 cases of positive of bacteria cultures in group A and B respectively,and the positive rate was 11.53% and 7.40% , negative in group C. There was a significant difference in positive result of bacteria culture （χ^2= 3. 103 ,P 〈0.05）. 72 hours after operation,there were 5 cases and 3 cases of positive of bacteria cultures in group A and B respectively,and the positive rate was 19.23% and 11.11% negative in group C. There was a significant difference in positive result of bacteria culture （χ^2= 5. 499,P 〈 0. 05 ）. There was a significant difference in postoperative incision infection rate. The value ofχ^2 is 3. 103 （P 〈0.05） and 4. 211 （P 〈0.05） respectively postoperative 2 days and 3 - 7 days. Conclusion ： In the nursing of patients subjected to disposable liquid drainage bag after total hip or knee joint arthroplasty,the drainage pack do not have to be changed every 24h or 48b. Draining the drainage bag to pull out the tube every 24 hours can be significantly reduced or eliminated the incision infection rate.