银离子敷料结合负压引流对胃肠肿瘤患者手术部位感染的预防

Effect of silver ion dressing combined with vacuum sealing drainage on treatment of gastrointestinal tumor patients with surgical site infections

目的探讨银离子敷料结合负压引流治疗胃肠肿瘤患者手术部位感染的效果。方法选取2014年1月-2016年10月医院收治的胃肠肿瘤行手术治疗后发生手术部位感染患者92例,随机分为观察组和对照组,每组各46例;对照组和观察组分别采用常规换药方法和银离子敷料结合负压引流法治疗;手术过程中采集引流液,进行病原菌检测;治疗1周后,比较两组患者的疗效、创面愈合时间、更换敷料次数等指标差异。结果观察组和对照组分别检出病原菌52株和54株,观察组中革兰阴性菌35株占67.31%,革兰阳性菌14株占26.92%,真菌3株占5.77%,对照组中革兰阴性菌38株占70.37%,革兰阳性菌14株占25.93%,真菌2株占3.70%,两组病原菌构成比比较差异无统计学意义;治疗1周后,观察组总有效率(95.65%)显著高于对照组(73.19%)(P<0.05),创面愈合时间和更换敷料次数均显著低于对照组(P<0.05)。结论银离子敷料结合负压封闭引流治疗胃肠肿瘤患者手术部位感染疗效显著,可有效促进创面愈合过程。

OBJECTIVE To explore the effect of silver ion dressing combined with vacuum sealing drainage on treatment of gastrointestinal tumor patients with surgical site infections.METHODS From Jan 2014 to Oct 2016,totally 92 patients with gastrointestinal tumor who had surgical site infections after surgical procedures were enrolled in the study and randomly divided into the observation group and the control group,with 46 cases in each group.The control group was treated with conventional drug dressing,and the observation group was treated with silver ion dressing combined with vacuum sealing drainage.The drainage fluid specimens were collected during the course of surgery so as to detect pathogens.The indexes such as curative effect,wound healing time and number of times of dressing change were observed and compared between the two groups of patients.RESULTS A total of 52 strains of pathogens were isolated in the observation group,including 35（67.31%）strains of gram-negative bacteria,14（26.92%）strains of gram-positive bacteria and 3（5.77%）strains of fungi;totally 54 strains of pathogens were isolated in the control group,including 38（70.37%）strains of gram-negative bacteria,14（25.93%）strains of gram-positive bacteria and 2（3.70%）strains of fungi;there was no significant difference in the constituent ratios of pathogens between the two groups.The total effective rate of the observation group was 95.65%after the treatment for 1 week,remarkably higher than 73.19%of the control group（P〈0.05）.The wound healing time of the observation group were significantly shorter than that of the control group,and the number of times of dressing change of the observation group was significantly less than that of the control group（P〈0.05）.CONCLUSION The silver ion dressing combined with vacuum sealing drainage can achieve significantly curative effect on the gastrointestinal tumors patients with surgical site infection and effectively facilitate the wound healing.