腹膜前引流在急性弥漫性腹膜炎手术中应用效果.docVIP

腹膜前引流在急性弥漫性腹膜炎手术中应用效果 　　[摘要] 目的 探讨腹膜前引流在急性弥漫性腹膜炎手术中的应用效果。 方法 回顾性分析106例急性弥漫性腹膜炎手术患者的切口愈合情况，其中治疗组54例在切口处腹膜前放置引流管并每天用甲硝唑液冲洗，对照组52例行常规关腹、未放置引流条。 结果 治疗组患者的切口感染率为11.11%，明显低于对照组的61.54%（P0.01）；治疗组患者的甲级愈合率为66.67%，明显高于对照组19.23%（P0.01）。 结论 在急性弥漫性腹膜炎患者手术中切口处腹膜前放置引流管，能有效降低手术切口感染率，促进切口甲级愈合。 　　[关键词] 腹膜前引流；弥漫性腹膜炎；手术；切口感染 　　[中图分类号] R656.4+1 [文献标识码] A [文章编号] 1674-4721（2014）09（b）-0053-02 　　Clinical application effect of preperitoneal drainage in surgery patients with acute diffuse peritonitis 　　MAO Zhu-xiang XU Xiao-ping 　　Department of General Surgery，People′s Hospital of Lean County in Jiangxi Province，Lean 344300，China 　　[Abstract] Objective To investigate the clinical application effect of preperitoneal drainage in surgery patients with acute diffuse peritonitis. Methods 106 patients with acute diffuse peritonitis after surgery operation had been retrospective analysed，54 cases in treatment group were treated with positioning preperitoneal drainage and daily irrigation with metronidazole，while the other 52 cases of the control group were treated with no preperitoneal drainage. Results The incision infection rate of treatment group was significantly lower than that of the control group （11.11% vs 61.54 %，P0.01），while the healing rate of grade A of treatment group were significantly higher than that of the control group （66.67% vs 19.23%，P0.01）. Conclusion The infection rate of incision of surgery patients with acute diffuse peritonitis can be improved by positioning preperitoneal drainage，and positioning preperitoneal drainage can also promote wound healing. 　　[Key words] Preperitoneal drainage；Diffuse peritonitis；Surgery；Infection of incision 　　术后腹壁切口感染是外科常见并发症之一，尤其是严重污染和化脓性感染的切口，术后感染率更高，使切口延迟愈合，可能发生切口裂开，甚至引起全身性感染。急性弥漫性腹膜炎手术患者，由于手术中切口污染严重（Ⅲ类切口），故手术后切口感染率较高，为了找到一种简便、经济、有效的预防该类手术患者切口感染的方法，本院分别采用常规关腹及缝合腹膜后在切口腹膜前放置引流管两种不同的方法治疗急性弥漫性腹膜炎，并对其效果进行比较。 　　1 资料与方法 　　1.1 一般资料 　　将本院2010年1月～2014年6月收治的106例急性弥漫性腹膜炎患者随机分为治疗组（腹膜前引流组）和对照组（常规关腹组）。治疗组54例，其中男34例，女20例，年龄最大82岁，最小14岁；原发疾病：上消化道穿