简易负压引流装置对妇科手术伤口愈合及感染、术后瘢痕、血清IL-2、IL-8和IL-10的影响
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摘要
目的探讨简易负压引流对妇科手术伤口愈合及感染、术后瘢痕、血清IL-2、IL-8和IL-10的影响。方法选取2016年3月至2018年3月延安市人民医院诊治的120例行妇科手术患者作为研究对象,采用随机数字法将其分为观察组和对照组,每组60例患者。观察组患者术后给予自制简易负压引流装置引流;对照组患者术后给予传统方式引流。系统观察:①两组患者术后切口愈合情况;②两组患者术后切口发生感染情况;③两组患者术后瘢痕情况;④两组患者术后血清IL-2、IL-8、IL-10。结果①观察组患者甲级愈合率显著高于对照组患者,其差异具有统计学意义(χ~2=6.75,P<0.05);②观察组患者甲级愈合例数及比例与总有效率均显著高于对照组患者,其差异均具有统计学意义(χ~2=7.13,5.83,均P<0.05);③对照组患者发生感染19例,占比31.7%,其中浅表感染16例,占比26.7%,深部感染3例,占比5.0%,观察组发生感染4例,占比6.7%,全部为浅表感染,观察组术后发生感染情况显著低于对照组(χ~2=8.15,P<0.05);④两组患者术后4周,疤痕面积差异均无统计学(t=0.76,均P>0.05),术后8周、12周、16周,疤痕面积差异均有统计学,观察组显著小于对照组(t=4.37,5.62,7.49,均P<0.05);⑤术后1周,两组患者IL-2、IL-8和IL-10比较,差异均具有统计学意义(t=6.78,7.23,6.95,均P<0.05)。结论简易负压引流相对于传统切口引流,能够显著改善患者术后切口愈合情况,降低切口感染发生概率,减少术后瘢痕面积,调节术后炎症表达,装置简易,操作简单,值得临床应用和推广。
Objective To explore the effect of simple negative pressure drainage device on wound healing and infection, postoperative scar, serum IL-2, IL-8 and IL-10 in gynecologic surgery. Methods 120 patients with gynecological tumors treated in Yan′an People′s Hospital from March 2016 to March 2018 were selected and divided into observation group(60 cases) and control group(60 cases). The control group received traditional drainage after operation. The observation group received self-made simple negative pressure drainage. Postoperative incision healing, postoperative incision infection, postoperative scar, serum IL-2, IL-8 and IL-10 in the two groups were observed. Results ① The grade A healing rate of observation group was significantly higher than that in control group, with statistically significant difference(χ~2=6.75, P<0.05). ②In the observation group, the number and proportion of grade A healing and total effective rate were significantly higher than these in control group, with statistically significant differences(χ~2=7.13, 5.83, P<0.05).③ In control group, there were 19 cases(31.7%) of infection, including 16 cases of superficial infection(26.7%) and 3 cases of deep infection(5.0%). In observation group, there were 4 cases of superficial infection(6.7%). The infection rate in observation group was significantly lower than that in control group(χ~2=8.15, P<0.05). ④There was no significant difference in scar area between the two groups at 4 weeks after operation(t=0.76, P>0.05). Differences in the scar area was statistically significant at 8 weeks, 12 weeks and 16 weeks after operation, and that of the observation group was significantly less than that of the control group(t=4.37, 5.62, 7.49, all P<0.05). ⑤ At a week after operation, the differences in IL-2, IL-8 and IL-10 between the two groups were statistically significant(t=6.78, 7.23, 6.95, all P<0.05). Conclusions Compared with the traditional negative pressure drainage, simple negative pressure drainage can significantly improve the postoperative wound healing, reduce the occurrence of wound infection, reduce postoperative scar area, expression and regulation of inflammation after operation, which is worthy of clinical application and popularization.
Objective To explore the effect of simple negative pressure drainage device on wound healing and infection, postoperative scar, serum IL-2, IL-8 and IL-10 in gynecologic surgery. Methods 120 patients with gynecological tumors treated in Yan′an People′s Hospital from March 2016 to March 2018 were selected and divided into observation group(60 cases) and control group(60 cases). The control group received traditional drainage after operation. The observation group received self-made simple negative pressure drainage. Postoperative incision healing, postoperative incision infection, postoperative scar, serum IL-2, IL-8 and IL-10 in the two groups were observed. Results ① The grade A healing rate of observation group was significantly higher than that in control group, with statistically significant difference(χ~2=6.75, P<0.05). ②In the observation group, the number and proportion of grade A healing and total effective rate were significantly higher than these in control group, with statistically significant differences(χ~2=7.13, 5.83, P<0.05).③ In control group, there were 19 cases(31.7%) of infection, including 16 cases of superficial infection(26.7%) and 3 cases of deep infection(5.0%). In observation group, there were 4 cases of superficial infection(6.7%). The infection rate in observation group was significantly lower than that in control group(χ~2=8.15, P<0.05). ④There was no significant difference in scar area between the two groups at 4 weeks after operation(t=0.76, P>0.05). Differences in the scar area was statistically significant at 8 weeks, 12 weeks and 16 weeks after operation, and that of the observation group was significantly less than that of the control group(t=4.37, 5.62, 7.49, all P<0.05). ⑤ At a week after operation, the differences in IL-2, IL-8 and IL-10 between the two groups were statistically significant(t=6.78, 7.23, 6.95, all P<0.05). Conclusions Compared with the traditional negative pressure drainage, simple negative pressure drainage can significantly improve the postoperative wound healing, reduce the occurrence of wound infection, reduce postoperative scar area, expression and regulation of inflammation after operation, which is worthy of clinical application and popularization.
引文
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[12] 李冰.妇产科腹部手术切口感染的原因和对策探讨[J].当代医学,2014,20(9):48-49.
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[14] 袁建菱,郭建生,左之文,等.妇科千金片对盆腔炎模型大鼠血清中IL-2、IL-6、IL-8含量的影响[J].中华中医药杂志,2013(1):250-252.
[15] 孔熙,石雯沁,吴能利.抗生素及微波对妇科急性盆腔炎患者血清IL-8、TGF-β_1的影响[J].海南医学院学报,2013,19(7):971-973.
[16] 任大宾,孙仁宇.白介素-10的抗炎功能及其分子机制[J].国际医学呼吸系统分册,2005,25(3):175-178.
[17] 聂兰军,宋辉,蔡薇,等.负压创面治疗技术的研究进展[J].感染、炎症、修复,2008,9(3):191-192.
[18] 陈波,贲道锋,夏照帆.负压创面治疗技术的研究应用进展[J].中华损伤与修复杂志(电子版),2014,9(2):69-73.
[19] 胡恺轩,章宏伟,周芳,等.两种负压创面治疗技术临床疗效比较[J].中华烧伤杂志,2009,25(4):253-257.
[2] 朱丽莉.腹腔镜下盆腔淋巴结清扫术与传统开腹手术在妇科恶性肿瘤治疗中的比较[J].包头医学院学报,2016,32(12):19-20.
[3] 陈慧,周思园,孙振球.常见妇科三大恶性肿瘤的流行及疾病负担研究现状[J].中国现代医学杂志,2015,25(6):108-112.
[4] 张大娟,聂义津,苏新宇.循证妇科恶性肿瘤腹式手术切口愈合不良原因[J].中国保健营养,2016(5下):182-183.
[5] 苏玉仁.妇产科手术后腹部切口感染的临床护理[J].当代医药论丛,2013,11(5):232-232.
[6] 蒋宏林,蒋静雯.妇科手术后病人伤口应用两种不同敷料的临床效果比较[J].护士进修杂志,2013,28(4):375-375.
[7] 叶斌斌,吴敏.开腹手术治疗与腹腔镜治疗妇科疾病的疗效对比[J].医药前沿,2014(14):242-242.
[8] 张晓华.妇产科腹部手术切口愈合不良的原因分析及护理[J].中国医药指南,2013,11 (14):331-332.
[9] 张林,卫兵,张曦,等.剖宫产术后子宫切口愈合不良的相关因素分析[J].中国妇幼保健,2014,29(15):2333-2335.
[10] 杨越波,沈慧敏,翁韬华,等.腹部手术切口愈合不良58例临床分析[J].中国基层医药,2008,15(2):226-227.
[11] 章霞,汪辉,刘涟.中药熏洗治疗妇科术后感染65例[J].河南中医,2015,35(6):1371-1373.
[12] 李冰.妇产科腹部手术切口感染的原因和对策探讨[J].当代医学,2014,20(9):48-49.
[13] 陈静,莫晖,李秋梅.剖宫产术皮内缝合切口愈合不良分析[J].吉林医学,2014,35(5):969-970.
[14] 袁建菱,郭建生,左之文,等.妇科千金片对盆腔炎模型大鼠血清中IL-2、IL-6、IL-8含量的影响[J].中华中医药杂志,2013(1):250-252.
[15] 孔熙,石雯沁,吴能利.抗生素及微波对妇科急性盆腔炎患者血清IL-8、TGF-β_1的影响[J].海南医学院学报,2013,19(7):971-973.
[16] 任大宾,孙仁宇.白介素-10的抗炎功能及其分子机制[J].国际医学呼吸系统分册,2005,25(3):175-178.
[17] 聂兰军,宋辉,蔡薇,等.负压创面治疗技术的研究进展[J].感染、炎症、修复,2008,9(3):191-192.
[18] 陈波,贲道锋,夏照帆.负压创面治疗技术的研究应用进展[J].中华损伤与修复杂志(电子版),2014,9(2):69-73.
[19] 胡恺轩,章宏伟,周芳,等.两种负压创面治疗技术临床疗效比较[J].中华烧伤杂志,2009,25(4):253-257.