肠道手术患者术前免疫功能及手术时间对术后切口感染的影响观察
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摘要
目的针对肠道手术患者术前免疫功能及手术时间对术后切口感染的影响进行观察研究,为临床数据提供参考。方法在手术前对患者用流式细胞仪进行T淋巴细胞亚群的测定,采用免疫比浊法的技术针对患者体内的免疫球蛋白、转铁蛋白以及血前白蛋白进行测定,记录患者的临床手术时间、及时判断患者的手术后切口是否发生感染,并进行药敏试验。结果手术前自身免疫功能低下的72例患者中,出现术后切口感染23例,切口感染率为31.94%;在手术前自身免疫功能正常的178例患者中,出现术后切口感染27例,切口感染率为13.48%,差异有统计学意义(P<0.05)。同时,手术时间不超过2 h的215例患者中,术后感染31例,其术后切口感染率为12.65%;在手术时间超过2 h的35例患者中,术后感染18例,其术后切口感染率为51.43%,差异有统计学意义(P <0.05)。结论针对肠道手术的患者,在手术前适当加强营养干预,增加患者的机体抵抗力,并且尽可能缩短患者的肠道手术时间,使手术时间尽量缩短至2 h以内,能够一定程度上降低肠道手术患者的术后切口感染风险。
Objective To investigate the effect of preoperative immune function and operation time on postoperative incision infection in patients undergoing intestinal surgery, and to provide reference for clinical data. Methods The T lymphocyte subsets were determined by flow cytometry before operation, and the immunoglobulin, transferrin and prealbumin were measured by immune turbidimetry. Record the clinical operation time of the patient, judge whether there are signs of infection in the incision after the operation, and once it is found that the patient is suspected to be infected, Cell culture and drugs should be carried out immediately on the local secretory products of the patient's incision. The sensitive experiment is used to determine whether the patient is given the injection and treatment of the sensitive antibacterial drugs. In the culture of the bacteria, the blood plate and the medium can be used to test the bacteria. If the dominant colony is cultivated, a fully automatic microorganism instrument is used to identify and test the bacteria. Results Among the 72 patients with low body immunity, 23 patients were infected by postoperative incision infection, the rate of incision infection was 31.94%. Among 178 patients with normal autoimmune function before operation, 27 patients had postoperative incision infection, and the rate of incision infection was 13.48%. The difference was statistically significant(P < 0.05).At the same time, of 215 patients who had been operated for less than 2 hours, 31 cases were infected, and the infection rate was 12.65. Of the 35 patients who had been operated for more than 2 hours, 18 cases were infected after surgery,the postoperative incision infection rate was 51.43%.,and the difference was statistically significant(P < 0.05). Conclusion For the patients undergoing intestinal surgery, nutrition absorption should be strengthened properly before operation, the body resistance of patients should be increased, and the time of intestinal operation should be shortened as far as possible, so that the operation time can be exhausted.Reducing the dose to less than 2 hours can reduce the risk of postoperative incision infection in patients with intestinal surgery.
Objective To investigate the effect of preoperative immune function and operation time on postoperative incision infection in patients undergoing intestinal surgery, and to provide reference for clinical data. Methods The T lymphocyte subsets were determined by flow cytometry before operation, and the immunoglobulin, transferrin and prealbumin were measured by immune turbidimetry. Record the clinical operation time of the patient, judge whether there are signs of infection in the incision after the operation, and once it is found that the patient is suspected to be infected, Cell culture and drugs should be carried out immediately on the local secretory products of the patient's incision. The sensitive experiment is used to determine whether the patient is given the injection and treatment of the sensitive antibacterial drugs. In the culture of the bacteria, the blood plate and the medium can be used to test the bacteria. If the dominant colony is cultivated, a fully automatic microorganism instrument is used to identify and test the bacteria. Results Among the 72 patients with low body immunity, 23 patients were infected by postoperative incision infection, the rate of incision infection was 31.94%. Among 178 patients with normal autoimmune function before operation, 27 patients had postoperative incision infection, and the rate of incision infection was 13.48%. The difference was statistically significant(P < 0.05).At the same time, of 215 patients who had been operated for less than 2 hours, 31 cases were infected, and the infection rate was 12.65. Of the 35 patients who had been operated for more than 2 hours, 18 cases were infected after surgery,the postoperative incision infection rate was 51.43%.,and the difference was statistically significant(P < 0.05). Conclusion For the patients undergoing intestinal surgery, nutrition absorption should be strengthened properly before operation, the body resistance of patients should be increased, and the time of intestinal operation should be shortened as far as possible, so that the operation time can be exhausted.Reducing the dose to less than 2 hours can reduce the risk of postoperative incision infection in patients with intestinal surgery.
引文
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[2]潘云,邓洪强,王文美.新生儿肠道手术术后肠道功能恢复及预后的危险因素分析[J].临床医药文献电子杂志,2017,4(26):5012-5013.
[3]夏侯海峰,丁根华,艾小刚.中西医结合预防肠道手术术后肠粘连34例[J].光明中医,2017,32(15):2236-2238.
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