四肢骨折术后切口感染灌洗结合封闭负压引流疗效

Efficacy of irrigation combined with closed negative pressure drainage and traditional lavage drainage in the treatment of incision infections after limb fracture surgery

目的针对四肢骨折术后切口感染的问题,采用灌洗结合封闭负压引流技术与传统灌洗引流技术两种不同方法治疗,探讨两种治疗方法的临床效果。方法选取2015-01至2016-01固安县人民医院四肢骨折术后感染48例,按照随机数字表法分为两组,每组24例。治疗组应用灌洗结合封闭负压引流技术治疗,对照组应用传统灌洗引流技术治疗。观察两组引流1、2周后引流液细菌培养转阴及3个月内感染复发的情况。观察两组抗菌素应用时间、拔管时间、伤口愈合时间及住院时间情况,并观察两组术后6个月Neer评分情况。结果 1、2周后治疗组创面细菌培养转阴率均高于对照组,两组比较差异均有统计学意义(P<0.05)。治疗组3个月内感染复发1例(4.17%),对照组3个月内感染复发2例(8.33%),两组比较差异无统计学意义。治疗组抗菌素应用时间、拔管时间、伤口愈合时间及住院时间均短于对照组,两组比较差异有统计学意义(P<0.05)。治疗组总有效率为95.84%,对照组总有效率为75.00%,治疗组疗效优于对照组,两组比较差异有统计学意义(P<0.05)。治疗组术后6个月Neer评分优于对照组,两组比较差异有统计学意义(P<0.05)。结论灌洗结合封闭负压引流技术对四肢骨折术后感染的控制、促进伤口愈合疗效确切,改善Neer评分。

Objective To compare the clinical effect of lavage combined with closed negative pressure drainage and that of traditional irrigation drainage. Methods Forty-eight patients with postoperative infections after surgery of limb fractures who were treated between January 2015 and January 2016 at Gu＇an County People＇s Hospital were selected,who were equally divided into two groups using the random number table method. Patients in the treatment group were treated with lavage combined with closed negative pressure drainage while the control group was treated with traditional lavage and drainage. The culture-negative rate1 and 2 weeks after drainage and the recurrence of infections within 3 months were observed in both groups. The duration of use of antibiotics,extubation time,wound healing time and hospital stay of the two groups were compared. The Neer score was observed 6 months after operation.Results After the first and second week,the negative rate of bacterial culture in the treatment group was higher than that in the control group with statistically significant difference（P〈0. 05）. There was one case of recurrence in the treatment group（4. 17%） and two cases in the control group（8. 33%） within three months. No statistically significant difference was found between the two groups.The antibiotic dose duration,extubation time,healing time and hospital stay of the treatment group were shorter than those of the control group,with statistically significant difference（P〈0. 05）. The Neer score of the treatment group 6 months after operation was better than that of the control group,and the difference was statistically significant between the two groups（P〈0. 05）. Conclusions Irrigation combined with closed negative pressure drainage technology can facilitate the control of infections after fracture of limbs,promote wound healing and improve the Neer score.