骶前灌洗、坐浴对老年直肠癌患者Miles术后会阴处切口感染的预防效果
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摘要
目的研究骶前灌洗、坐浴对老年直肠癌患者Miles术后会阴处切口感染的预防效果。方法选择在本院确诊为直肠癌并行Miles术的老年患者进行研究观察,将60例患者按照随机数表法分成观察组和对照组(各30例),对照组以常规换药护理切口,观察组则采用骶前灌洗、坐浴法。比较两组患者的引流管留置和残腔消失所用时间、患者的换药次数和费用及切口总引流量,并比较两组患者术后切口一期愈合率和切口感染率。结果两组患者的总引流量、引流管留置时间和残腔消失时间比较,差异无统计学意义(P>0.05);观察组的换药次数与对照组相比,差异有统计学意义(P<0.05)。观察组患者一期愈合率(86.67%)明显高于对照组(63.33%),观察组伤口感染率(6.67%)明显低于对照组(26.67%)(P<0.05)。结论骶前灌洗、坐浴可以有效预防老年直肠癌患者Miles术后会阴处切口的感染,该方法安全可行,值得临床推广运用。
Objective To study the prevention effect on perineal incision infection of presacral irrigation, sitz bath for postoperative rectal cancer by Miles. Methods 60 cases in our hospital who were diagnosed as rectal cancer and treated by Miles operation were researched, they were divided into the observation group and the control group(30 cases in each group) by random number table method, the control group with routine dressing method incision nursing, the observation group with presacral irrigation, bath the nursing methods of incision. Compared the two groups' indwelling catheter indwelling time, the times of dressing change and cost, residual cavity disappeared time and the total discharge of incision, and compared the two groups of patients with the first phase of wound healing rate and incision infection rate. Results Their drainage tube indwelling time, residual cavity disappearance time and total volume of drainage had no difference(P > 0.05), the observation group' number of dressing is obviously was less than that of the control group, the difference was statistically significant(P < 0.05).The first rate of observation group(86.67%) was significantly more than the control group(63.33%) and the observation group' wound infection rate(6.67%) was significantly less than the control group(26.67%), the difference was statistically significant(P<0.05). Conclusion Presacral irrigation, sitz bath, can effectively prevent perineal incision infection of rectal cancer after Miles operation. The method is safe and feasible, it is worth of clinical application.
Objective To study the prevention effect on perineal incision infection of presacral irrigation, sitz bath for postoperative rectal cancer by Miles. Methods 60 cases in our hospital who were diagnosed as rectal cancer and treated by Miles operation were researched, they were divided into the observation group and the control group(30 cases in each group) by random number table method, the control group with routine dressing method incision nursing, the observation group with presacral irrigation, bath the nursing methods of incision. Compared the two groups' indwelling catheter indwelling time, the times of dressing change and cost, residual cavity disappeared time and the total discharge of incision, and compared the two groups of patients with the first phase of wound healing rate and incision infection rate. Results Their drainage tube indwelling time, residual cavity disappearance time and total volume of drainage had no difference(P > 0.05), the observation group' number of dressing is obviously was less than that of the control group, the difference was statistically significant(P < 0.05).The first rate of observation group(86.67%) was significantly more than the control group(63.33%) and the observation group' wound infection rate(6.67%) was significantly less than the control group(26.67%), the difference was statistically significant(P<0.05). Conclusion Presacral irrigation, sitz bath, can effectively prevent perineal incision infection of rectal cancer after Miles operation. The method is safe and feasible, it is worth of clinical application.
引文
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[8]余加和,黄项武,董志勇,等.自制双套管持续冲洗治疗腹腔镜低位直肠癌根治术后吻合口瘘[J].河北医科大学学报,2015,23(4):408-411.
[9]朱建明,王文强,钱小毛,等.结直肠癌患者术后切口感染的危险因素与防治措施[J].中华医院感染学杂志,2015,12(9):2086-2088.
[10]王少勇,张忠民,黄进堂,等.结直肠癌患者手术部位感染病原菌与耐药性研究[J].中华医院感染学杂志,2015,21(15):3434-3436.
[11]邓修民,肖进.碘伏灌洗在左半直肠癌并肠梗阻手术治疗中的疗效分析[J].结直肠肛门外科,2013,19(1):33-35.
[2]张小龙,高枫,陈利生,等.结直肠肛管癌3197例流行病学分析[J].结直肠肛门外科,2008,14(1):8-11.
[3]Modesto J Colon,Patrick Le Masters,Phillipa Newell,,Laparoendoscopic Single Site(LESS)Splenectomy with a Conventional Laparoscope and Instruments[J].JSLS.2011Jul-Sep;15(3):384–386.
[4]王大全,傅传刚,孟荣贵,等.结直肠类癌手术方法的选择[J].结直肠肛门外科,2008,14(6):388-392.
[5]Khosla Arjun,Ponsky Todd.Use of operative laparoscopes in single-port surgery:The forgotten tool[J].Journal of Minimal Access Surgery,2011 Jan-Mar;7(1):116–120.
[6]赵建芳,姚一多.坐浴对肛周脓肿术后创面愈合作用的研究进展[J].结直肠肛门外科,2012,18(6):407-408.
[7]蔡碧娥,史冬雷,史莉娜,等.直肠癌患者Miles术后骶前持续灌洗的护理[J].护理学杂志,2009,24(4):35-37.
[8]余加和,黄项武,董志勇,等.自制双套管持续冲洗治疗腹腔镜低位直肠癌根治术后吻合口瘘[J].河北医科大学学报,2015,23(4):408-411.
[9]朱建明,王文强,钱小毛,等.结直肠癌患者术后切口感染的危险因素与防治措施[J].中华医院感染学杂志,2015,12(9):2086-2088.
[10]王少勇,张忠民,黄进堂,等.结直肠癌患者手术部位感染病原菌与耐药性研究[J].中华医院感染学杂志,2015,21(15):3434-3436.
[11]邓修民,肖进.碘伏灌洗在左半直肠癌并肠梗阻手术治疗中的疗效分析[J].结直肠肛门外科,2013,19(1):33-35.