氯已定和聚维酮碘预防外科术后伤口感染的临床分析

Efficacy of chlorhexidine and povidone iodine in preventing surgical site infections

目的分析氯已定和聚维酮碘预防术后伤口感染的临床疗效。方法选取2015年1月-2017年1月于医院施行肛周、腹部开放手术患者200例为研究对象,随机分为试验组和对照组,各100例,试验组患者以质量分数2%氯已定进行皮肤消毒,对照组患者以质量分数5%聚维酮碘消毒,对两组患者的临床资料及结局指标进行分析。结果试验组术后高热10例,低热30例,总发热率为40.00%(40/100);对照组术后高热15例,低热40例,总发热率为55.00%(55/100),两组术后总发热率差异有统计学意义(P=0.034);试验组术后伤口感染率为6.00%(6/100)低于对照组15.00%(15/100)(P=0.044);两组患者术后白细胞计数<10×109/L、≤10~15×109/L,>15×109/L的患者,差异具有统计学意义(P=0.021);试验组住院时间为(23.10±3.20)d短于对照组(23.50±3.40)d,但差异无统计学意义(P=0.393)。结论氯已定在预防外科手术后的总感染率及浅表部位感染率较聚维酮碘更有优势。

OBJECTIVE To evaluate the clinical efficacy of chlorhexidine and povidone iodine in preventing postoperative wound infections,in order to provide reference for clinical medication.METHODS 200 cases of patients who underwent perianal and abdominal open surgery in our hospital from Jan.2015 to Jan.2017 were enrolled.Patients were randomly divided into experimental group（100 cases）and control group（100 cases）.Patients in the experimental group were treated with 2% chlorine for skin disinfection.In the control group,patients were disinfected with 5% povidone iodine.The basic clinical data and outcomes of the two groups were recorded.RESULTS The postoperative incidence rate of hyperpyrexia was 10.00% in the experimental group,the incidence rate of lowgrade fever was 30.00%,and the total incidence rate of fever was 40.00%.In the control group,there were 15 cases of hyperpyrexia and 40 cases of low-grade fever,and the total postoperative fever incidence rate was 55.00%.The difference between the two groups was significant（P=0.03）.The occurrence rate of postoperative wound infection in the experimental group was significantly lower than that in the control group（6.00% vs.15.00%,P=0.04）.The incidence rates with white blood cell count of〈10×10^ 9/L,≤10-15×10^ 9/L,〉15×10 ^9/L in the experimental group were lower than those in the control group（P=0.02）.There was no significant difference in the length of stay between the two groups,which were（23.10±3.20）d and（23.50±3.40）d,respectively（P=0.39）.CONCLUSIONChlorine showed advantages over povidone iodine in preventing postoperative infections and superficial infections.