聚维酮碘稀释液与甲硝唑冲洗腹腔在化脓穿孔性阑尾炎患儿术后的应用效果分析

Analyze the application effect of povidone iodine diluent and metronidazole in abdominal cavity flushing in children with suppurative perforated appendicitis after operation

目的:分析聚维酮碘稀释液与甲硝唑冲洗腹腔在化脓穿孔性阑尾炎患儿术后应用效果。方法:收集2021年8月至2022年9月收治的62例化脓穿孔性阑尾炎患儿的临床资料,按抗感染方式分为聚维酮碘组(n=32)与甲硝唑组(n=30),比较两组患儿术后恢复情况,记录肠鸣音出现时间、术后首次肛门排气时间、首次排便时间、体温恢复正常时间、术后住院时间、切口愈合时间;比较两组患儿术前、术后3 d血清炎症因子水平[白介素6(Interleukin-6,IL-6)、C反应蛋白(C-reactive protein,CRP)、肿瘤坏死因子α(Tumor necrosis factorα,TNF-α)、白细胞计数(White blood cell count,WBC)]的变化;记录并发症发生率。结果:聚维酮碘组肠鸣音出现时间、术后首次肛门排气时间、首次排便时间、体温恢复正常时间、术后住院时间及切口愈合时间均较甲硝唑组短(P<0.05);聚维酮碘组切口愈合分级优于甲硝唑组(P<0.05),甲级愈合所占比例高于甲硝唑组(P<0.05);聚维酮碘组术后3 d血清IL-6、TNF-α、CRP、WBC均低于甲硝唑组(P<0.05);聚维酮碘组并发症发生率略低于甲硝唑组,但组间对比差异未呈现统计学意义。结论:聚维酮碘稀释液冲洗腹腔较甲硝唑冲洗更能减轻化脓穿孔性阑尾患儿术后炎症反应,促进切口愈合,减少并发症发生,促进患儿恢复。

Objective:To investigate the the application effect of povidone iodine diluent and metronidazole in abdominal cavity flushing in children with suppurative perforated appendicitis after operation.Methods:The clinical data of 62 children with suppurative and perforated appendicitis admitted to the hospital from August 2021 to September 2022 were collected.According to different anti-infection methods,the children were divided into povidone-iodine group(n=32)and metronidazole group(n=30).The postoperative recovery was compared between the groups.The appearance time of bowel sounds,postoperative first anal exhaust time,first defecation time,time of temperature returning to normal,postoperative hospitalization time and incision healing time were recorded.Changes in the levels of serum inflammatory factors[interleukin-6(IL-6),C-reactive protein(CRP),tumor necrosis factorα(TNF-α)and white blood cell count(WBC)]before operation and on day 3 after operation were compared between the groups.The incidence of complications was recorded.Results:The appearance time of bowel sounds,postoperative first anal exhaust time,first defecation time,time of temperature returning to normal,postoperative hospitalization time and incision healing time in the povidone-iodine group were shorter than those in the metronidazole group(P<0.05).The grade of incision healing in the povidone-iodine group was better than that in the metronidazole group(P<0.05),and the proportion of grade A healing was higher than that in the metronidazole group(P<0.05).On day 3 after operation,serum IL-8,TNF-α,CRP and WBC in the povidone-iodine group were lower than those in the metronidazole group(P<0.05).The incidence of complications in the povidone-iodine group was slightly lower than that in the metronidazole group(P>0.05).Conclusion:Compared with metronidazole,abdominal cavity irrigation with povidone-iodine diluent can alleviate postoperative inflammatory reactions in children with suppurative and perforated appendicitis more significantly,promote incision healing,reduce complications,and promote recovery.