臭氧水灌洗脓腔对直肠肛管周围脓肿切开引流术后肉芽状态、病原菌分布的影响

Effect of Ozone Water Lavage of Abscess Cavity on Granulation Status and Distribution of Pathogenic Bacteria after Incision and Drainage of Perianal Abscess

目的:探讨臭氧水灌洗脓腔治疗方案应用于直肠肛管周围脓肿切开引流术后的效果。方法:选取2018年1月-2021年8月江门市新会陈经纶医院收治的直肠肛管周围脓肿患者108例,按随机数字表法分为两组,各54例。两组均行切开引流术,对照组采用持续负压吸引,观察组在对照组基础上采用臭氧水灌洗脓腔。比较两组治疗总有效率、创面情况(腐肉脱落、新生上皮出现与创面愈合时间)、治疗前与治疗1周后创面分泌物评分、创面四周组织水肿评分、创口疼痛程度评分、肉芽状态评分、治疗1周后病原菌分布情况。结果:观察组治疗总有效率100%(54/54),高于对照组的81.48%(44/54),差异有统计学意义(P<0.05);观察组腐肉脱落、新生上皮出现时间早于对照组,创面愈合时间短于对照组,差异有统计学意义(P<0.05);治疗1周后,观察组创面分泌物、创面四周组织水肿、创口疼痛程度、肉芽状态评分明显低于对照组,差异有统计学意义(P<0.05);观察组共培养出病原菌14株,革兰阴性菌10株、革兰阳性菌4株,对照组共培养出病原菌24株,革兰阴性菌17株、革兰阳性菌5株、真菌2株,主要病原菌均是大肠埃希菌、肺炎克雷伯杆菌、金黄色葡萄球菌。结论:直肠肛管周围脓肿切开引流术后使用臭氧水灌洗脓腔疗效显著,可促进创面愈合,减轻创口疼痛与水肿,减少创面分泌物与病原菌。

Objective:To investigate the effect of ozone water lavage of abscess cavity after incision and drainage of perianal abscess.Method:A total of 108 patients with perianal abscess admitted to Xinhui Chen Jinglun Hospital of Jiangmen City from January 2018 to August 2021 were selected and divided into two groups according to random number table method,with 54 cases in each group.Both groups were treated with incision and drainage,the control group was treated with continuous negative pressure suction,and the observation group was treated with ozone water lavage based on the control group.The total effective rate,wound condition(the time of shedding of carrion,emergence of new epithelium and wound healing),wound secretion scores before treatment and 1 week after treatment,tissue edema score around the wound,wound pain scores,granulation status scores,and the distribution of pathogenic bacteria after 1 week of treatment were compared between the two groups.Result:The total effective rate of observation group was 100%(54/54),which was higher than 81.48%(44/54)of control group,and the difference was statistically significant(P<0.05).The time of shedding of carrion,emergence of new epithelium in observation group were earlier than those in control group and wound healing in observation group was shorter than that in control group,and the differences were statistically significant(P<0.05).After 1 week of treatment,wound secretion scores,tissue edema scores,wound pain score and granulation status scores in the observation group were significantly lower than those in the control group,and the differences were statistically significant(P<0.05).A total of 14 strains of pathogenic bacteria were cultured in the observation group,including 10 strains of Gram-negative bacteria and 4 strains of Gram-positive bacteria,while 24 strains of pathogenic bacteria were cultured in the control group,including 17 strains of Gram-negative bacteria,5 strains of Gram-positive bacteria and 2 strains of fungi.The main pathogens were Escherichia coli,Klebsiella pneumoniae and Staphylococcus aureus.Conclusion:After incision and drainage of perianal abscess,it is effective to irrigate abscess cavity with ozone water,which can promote wound healing,reduce wound pain and edema,and reduce wound secretion and pathogenic bacteria.