负压创面治疗在结直肠癌切除术患者回肠造口术后应用的效果

Effect of negative-pressure wound therapy after ileostomy on patients undergoing colorectal cancer surgery

目的评估负压创面治疗(NPWT)在结直肠癌切除术患者回肠造口术后应用的有效性。方法抽取2018年1月至2021年1月于西山煤电(集团)有限责任公司职工总医院接受回肠造瘘术治疗的结直肠癌患者100例,依据随机抽签法分为观察组与对照组,每组50例。观察组予以术后预防性NPWT,对照组给予常规治疗,对比两组患者围术期及术后情况、术后切口愈合并发症及手术部位感染发生情况。结果两组手术时间、术中失血量及术后住院时间比较差异未见统计学意义(P>0.05)。观察组术后出现并发症7例,少于对照组的18例(P<0.05),但两组术后Clavien-Dindo并发症分级系统分级情况比较差异未见统计学意义(P>0.05)。观察组切口完全愈合时间[(6.93±1.07)d]少于对照组[(8.28±1.14)d],P<0.05。观察组出现切口愈合并发症5例,其中手术部位感染3例;对照组出现切口愈合并发症15例,其中手术部位感染11例,两组比较差异有统计学意义(P<0.05)。结论结直肠癌患者改行回肠造口关闭术后NPWT可降低切口相关并发症和手术部位感染的发生率。

Objective To evaluate the effect of negative-pressure wound therapy(NPWT)after ileostomy on patients undergoing colorectal cancer surgery.Methods A total of 100 patients with colorectal cancer who underwent ileostomy treatment in Xishan Coal Electricity Group Co.,Ltd.Staff General Hospital from January 2018 to January 2021 were selected,and they were divided into observation group and control group according to the random drawing method,with 50 cases in each group.The observation group was given postoperative preventive NPWT,and the control group was given conventional treatment.The perioperative and postoperative conditions,postoperative wound healing complications,and surgical site infection were compared between the two groups.Results There was no significant difference in operation time,intraoperative blood loss and postoperative hospital stay between the two groups(P>0.05).Postoperative complications occurred in 7 cases in the observation group,which was less than 18 cases in the control group(P<0.05).But there was no significant difference in the grading of Clavien Dindo complication grading system between the two groups(P>0.05).The complete healing time of incision in the observation group was(6.93±1.07)d,shorter than the(8.28±1.14)d in the control group(P<0.05).There were 5 cases of wound healing complications in the observation group,including 3 cases of surgical site infection;and there were 15 cases of wound healing complications in the control group,including 11 cases of surgical site infection,and the difference between the two groups was statistically significant(P<0.05).Conclusions NPWT after ileostomy closure for patients with colorectal cancer can reduce the incidence of wound healing complications and surgical site infections.