切口局部冰袋冷敷联合红外线照射在腹股沟斜疝术后中的应用效果

Effect of local ice pack cold compress combined with infrared radiation for patients with inguinal hernia after surgery

目的探讨腹股沟斜疝患者在手术后采用切口局部冰袋冷敷联合红外线照射治疗的临床效果。方法采用回顾性分析,选择2021年1月至2022年12月在广州市第一人民医院接受手术治疗的腹股沟斜疝患者88例,按照术后处理方式不同分为对照组和治疗组。对照组44例,男39例、女5例,发病至手术时间(6.35±0.52)d,年龄(49.43±2.89)岁;左侧腹股沟疝17例、右侧腹股沟疝27例;术后接受砂袋+红外线照射治疗。治疗组44例,男37例、女7例,发病至手术时间(6.16±0.79)d,年龄(49.16±2.73)岁,左侧腹股沟疝18例、右侧腹股沟疝26例;术后接受切口局部冰袋冷敷联合红外线照射治疗。两组均治疗1周。对比两组治疗效果及治疗前后的相关评价指标。统计比较采用χ^(2)检验、独立样本t检验。结果治疗组患者切口愈合总有效率为93.18%(41/44),高于对照组的75.00%(33/44),差异有统计学意义(χ^(2)=5.436,P=0.020);治疗后,治疗组视觉模拟量表(VAS)评分为(1.23±0.08)分、舒适度评分为(18.39±2.17)分、白细胞介素(IL)-10为(4.32±1.08)ng/L、C反应蛋白(CRP)(4.43±1.68)ng/L、白细胞计数(WBC)为(4.13±0.75)×10^(9)/L,对照组分别为(5.30±0.25)分、(15.24±2.25)分、(6.95±2.16)ng/L、(6.16±2.05)ng/L、(7.75±1.62)×10^(9)/L,差异均有统计学意义(均P<0.05);治疗组切口延迟愈合发生率为2.27%(1/44)、切口感染发生率为0、切口渗血发生率为2.27%(1/44),均低于对照组[20.45%(9/44)、11.36%(5/44)、18.18%(8/44)],差异均有统计学意义(均P<0.05);治疗组切口换药次数[(3.67±1.29)次]少于对照组[(6.98±1.53)次],切口愈合时间[(6.10±1.42)d]、住院总时间[(4.29±1.24)d]短于对照组[(9.24±1.61)d、(8.62±2.55)d],差异均有统计学意义(均P<0.05);治疗组切口敷料渗血Ⅰ级36例、Ⅱ级8例、Ⅲ级0例,对照组分别为18例、19例、7例,差异均有统计学意义(均P<0.05)。结论腹股沟斜疝患者在手术后采用切口局部冰袋冷敷联合红外线照射治疗效果显著,可有效控制切口敷料渗血,减少换药次数,减轻炎症反应和疼痛程度,缩短切口愈合和住院时间,提高舒适度。

Objective To study the clinical effect of local ice pack cold compress combined with infrared radiation for patients with inguinal hernia after surgery.Methods A total of 88 patients with inguinal hernia who underwent surgical treatment at the Guangzhou First People's Hospital from January 2021 to December 2022 were selected.The patients were divided into a control group and a treatment group according to different postoperative treatments,with 44 cases in each group.In the control group,there were 39 males and 5 females;the time from onset to surgery was(6.35±0.52)d;they were(49.43±2.89)years old;there were 17 cases of left inguinal hernia and 27 cases of right inguinal hernia;they were treated with sandbags and infrared radiation after surgery.In the treatment group,there were 37 males and 7 females;the time from onset to surgery was(6.16±0.79)d;they were(49.16±2.73)years old;there were 18 cases of left inguinal hernia and 26 cases of right inguinal hernia;they were treated with local ice pack cold compress and infrared radiation after surgery.Both groups were treated for 1 week.The therapeutic effects and the relevant evaluation indexes before and after treatment were compared between the two groups.χ^(2)and independent sample t test were used for statistical comparison.Results The total effective rate of incision healing in the treatment group was higher than that in the control group[93.18%(41/44)vs.75.00%(33/44)],with a statistical difference between the two groups(χ^(2)=5.436,P=0.020).After the treatment,the scores of Visual Analogue Scale and comfort,the levels of interleukin(IL)-10 and C reaction protein,and white blood cell count in the treatment group were better than those in the control group[(1.23±0.08)vs.(5.30±0.25),(18.39±2.17)vs.(15.24±2.25),(4.32±1.08)ng/L vs.(6.95±2.16)ng/L,(4.43±1.68)ng/L vs.(6.16±2.05)ng/L,and(4.13±0.75)×10^(9)/L vs.(7.75±1.62)×10^(9)/L],with statistical differences(all P<0.05).The incidences of delayed wound healing,wound infection,and wound bleeding in the treatment group were lower than those in the control group[2.27%(1/44)vs.20.45%(9/44),0 vs.11.36%(5/44),and 2.27%(1/44)vs.18.18%(8/44)],with statistical differences(all P<0.05).The number of incision dressing changes in the treatment group was lower than that in the control group[(3.67±1.29)times vs.(6.98±1.53)times],with a statistical difference(P<0.05).The incision healing time and the total hospitalization time in the treatment group were shorter than those in the control group[(6.10±1.42)d vs.(9.24±1.61)d and(4.29±1.24)d vs.(8.62±2.55)d],with statistical differences(both P<0.05).In the treatment group,36 cases had gradeⅠbleeding,8 gradeⅡ,and 0 gradeⅢ;in the control group,18 cases had gradeⅠbleeding,19 gradeⅡ,and 7 gradeⅢ;there was a statistical difference(all P<0.05).Conclusion Local ice pack cold compress combined with infrared radiation for patients with inguinal hernia after surgery can effectively control wound dressing bleeding,reduce dressing changes,inflammatory reactions,and pain level,shorten wound healing time,and hospitalization time,and improve comfort.