围术期辅助供氧治疗对跟骨骨折手术术后切口感染的影响

发布时间：2018-02-24 09:01

本文关键词： 围术期辅助供氧感染　出处：《中华医院感染学杂志》2017年10期 　论文类型：期刊论文

【摘要】：目的探讨辅助供氧治疗对跟骨骨折手术术后切口感染的影响,以期为跟骨骨折术后切口感染预防措施的选择提供参考。方法选取医院2013年9月-2016年8月择期行跟骨骨折切开复位内固定术的患者226例,随机分为试验组和对照组,每组各113例;实施全身麻醉后,试验组将氧浓度调整至80%,对照组将氧浓度调整至30%,氧流量2L/min,记录两组患者术后14d内手术部位感染、创口边缘坏死、跟骨骨髓炎、因感染再次手术的发生率,并记录患者术后肺不张、术后肺部感染发生情况。结果试验组患者术后14d手术部位感染4例,感染率为3.5%,对照组手术部位感染12例,感染率为10.6%,试验组患者术后14d手术部位感染率明显低于对照组(P0.05);试验组术后14d创口边缘坏死共7例(6.1%),而对照组创口边缘坏死共19例(16.8%),两组比较差异有统计学意义(P0.05);试验组患者因感染再次手术3例(2.7%),对照组因感染再次手术共10例(8.8%),试验组患者因感染再次手术率明显低于对照组(P0.05);试验组与对照组患者跟骨骨髓炎发生率差异无统计学意义。结论围术期辅助供氧治疗能够显著降低跟骨骨折患者术后切口感染率且不增加肺部并发症发生率;在预防切口感染及其相关并发症方面具有明显优势,值得推广应用。
[Abstract]:Objective to investigate the effect of auxiliary oxygen supply on incision infection after operation of calcaneal fracture. Methods from September 2013 to August 2016, 226 patients undergoing open reduction and internal fixation of calcaneal fractures were randomly divided into two groups: the experimental group and the control group. After general anesthesia, the experimental group adjusted the oxygen concentration to 80 and the control group adjusted the oxygen concentration to 300.The oxygen flow rate was 2L / min. The infection of operation site, wound edge necrosis and calcaneal osteomyelitis were recorded in both groups within 14 days after operation. The incidence of reoperation due to infection and the incidence of postoperative atelectasis and postoperative pulmonary infection were recorded. Results in the experimental group, 4 patients were infected at the surgical site 14 days after operation, and the infection rate was 3.5, while in the control group, 12 patients were infected at the surgical site. The infection rate was 10.6. The infection rate of the patients in the test group was significantly lower than that in the control group on the 14th day after operation (P 0.05), in the test group there were 7 patients with marginal necrosis of the wound on the 14th day after operation, while in the control group, there were 19 patients with marginal necrosis of the wound. There was a significant difference between the two groups. The incidence of calcaneal osteomyelitis in experimental group and control group was significantly lower than that in control group. Conclusion Perioperative supplementary oxygen therapy can significantly reduce the postoperative incision infection rate in patients with calcaneal fracture and do not increase the incidence of pulmonary complications. It has obvious advantages in preventing incision infection and its related complications, and is worth popularizing.
【作者单位】：诸暨市第六人民医院麻醉科;诸暨市中医院麻醉科;浙江大学医学院附属第二医院麻醉科;诸暨市中心医院麻醉科;绍兴市中医院麻醉科;
【基金】：浙江省医学会临床科研基金资助项目(2014ZYC-A02)
【分类号】：R687.3

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