胃肠道肿瘤术后腹部切口深层裂开的VSD治疗及危险因素分析

VSD treatment and risk factors analysis of deep split of abdominal incision after gastrointestinal tumor surgery

目的探讨负压封闭引流术(VSD)在胃肠道肿瘤术后腹部切口深层裂开的应用价值,并分析腹部切口感染的危险因素。方法回顾性分析2015年10月~2019年10月在我院收治的114例胃肠道肿瘤根治术患者的临床资料,其中术后腹部切口深层感染裂开并行VSD治疗的患者11例(感染裂开组),无术后切口感染者103例(正常愈合组),分析VSD治疗疗效及影响腹部切口感染裂开的危险因素。结果11例腹部切口深层裂开的患者行VSD治疗后均治愈出院,无再次手术。单因素分析结果显示,体重指数、手术时机、术中腹腔感染、切口皮下引流是影响腹部切口感染裂开的相关因素,差异有统计学意义(P<0.05)。多因素分析结果显示,手术时机(急诊)、术中腹腔感染是影响腹部切口感染的独立危险因素,切口皮下引流是影响腹部切口感染的独立保护因素,差异有统计学意义(P<0.05)。结论胃肠道肿瘤术后腹部切口深层裂开应用VSD治疗,能有效促进切口的愈合,减少并发症的发生,而切口皮下引流是腹部切口感染裂开的保护性因素。

Objective To explore the application value of vacuum sealing drainage(VSD)in deep split of abdominal incision after gastrointestinal tumor surgery,and to analyze the risk factors of abdominal incision infection.Methods The clinical data of 114 patients undergoing radical gastrointestinal tumor surgery in our hospital from October 2015 to October 2019 were retrospectively analyzed,including 11 patients with deep split of the abdominal incision after the operation and VSD treatment(infection split group),and 103 cases without postoperative incision infection(normal healing group).The therapeutic effect of VSD and the risk factors affecting the infection of abdominal incision were analyzed.Results 11 patients with deep split of the abdominal incision were cured and discharged after VSD treatment without reoperation.Univariate analysis showed that body mass index,timing of surgery,intraabdominal infection and incisional subcutaneous drainage were related factors affecting abdominal incision infection,and the difference was statistically significant(P<0.05).The results of multivariate analysis showed that the timing of surgery(emergency)and intra-abdominal infection were independent risk factors affecting abdominal incision infection,and incisional subcutaneous drainage was an independent protective factor affecting abdominal incision infection,and the difference was statistically significant(P<0.05).Conclusion VSD treatment of abdominal incision after gastrointestinal tumor surgery can effectively promote the healing of the incision and reduce the occurrence of complications.Incisional subcutaneous drainage is a protective factor for the infection of the abdominal incision.