新型冲洗水球预防腰椎后路术中感染的研究

Infection prevention of new-type bulb syringe during posterior lumbar surgery

目的:探讨新型可连续脉冲冲洗水球在腰椎后路融合手术中预防感染的作用。方法:选取某院2016年6—12月接受多节段腰椎后路融合手术的患者30例,随机分为2组,术中应用新型脉冲冲洗水球者15例(实验组),应用常规倾倒冲洗者15例(对照组),比较2组患者术中冲洗时间,术后1、3、5 d C-反应蛋白变化趋势,术后发热病例、切口愈合情况及拆线时间。结果:2组患者术中冲洗时间:实验组[(2.13±0.15)min]明显短于对照组[(5.59±1.24)min];术后1、3、5 d C-反应蛋白变化趋势:实验组数值呈下降趋势(46、19、5 mg/L),对照组数值呈增高趋势(49、52、61 mg/L);切口渗出:实验组为0例,对照组为3例;切口拆线时间:实验组(11.57 d)明显短于对照组(14.29 d);术后3、5 d体温变化:实验组[(37.1±2.26)、(37.0±0.12)℃]低于对照组[(38.2±3.34)、(37.5±0.25)℃],差异有统计学意义(P<0.05);2组患者术后均未出现切口感染。结论:与常规倾倒冲洗方法相比,可连续脉冲冲洗水球使用方便、冲洗时间短,且能减少患者术后切口内局部炎症反应,值得临床推广与应用。

Objective To study the infection prevention effect of a new type of bulb syringe during posterior lumbar surgery,which can execute pulse irrigation continuously.Methods Totally 30 patients undergoing multi-level posterior lumbar interbody fusion surgery from June to December 2016 were divided into an experiment group and a control group.The experiment group applied the bulb syringe, and the control group used tipping irrigation.The two groups were compared on intraoperative irrigation time, the development trend of C-reactive protein（CRP） 1, 3 and 5 days after surgery, incidence of postoperative pyrexia, wound healing and suture-removal time.Results The experimental group had the intraoperative irrigation time being（2.13±0.15）min, which was significantly shorter than that [（5.59±1.24）min] in the control group.In the experimental group, the CRP measurement values 1, 3 and 5 days after surgery were 46, 19 and 5 mg/L respectively and showed adeclining trend; in the control group, the CRP measurement values 1, 3 and 5 days after surgery were 49, 52 and 61 mg/L respectively and showed an increasing trend.There were 3 cases of incision exudation in the control group while none in the experimental group.The experimental group had the suture-removal time being 11.57 d, which was statistically less than that（14.29 d） in the control group.The body temperature 3 and 5 days after surgery was（37.1±2.26） and（37.0±0.12）℃respectively in the experimental group while（38.2 ±3.34） and（37.5±0.25）℃ in the control group, and there were obvious differences between the two groups（P〈0.05）.There were no infected incision occurred in the two groups.Conclusion The bulb syringe gains advantages over the traditional irrigation in easy operation, short time and incidence of infected incision,and thus is worthy promoting clinically.