封闭式负压引流在股骨颈手术中应用.docVIP

封闭式负压引流在股骨颈手术中应用 　　 摘 要 目的：探讨封闭式负压引流对股骨颈手术切口感染的影响。方法：将157例股骨颈手术患者随机分为观察组和对照组，观察组87例，常规手术后切口施行封闭式负压引流，连接扬州产无菌一次性负压引流器，持续负压引流约72小时左右；对照组70例在接受常规手术后切口采用传统橡皮管自然引流法。结果：观察组切口感染率明显低于对照组(P＜0.05)，观察组平均住院日及住院费用明显低于对照组(P＜0.01)。结论：封闭式负压引流较传统橡皮管自然引流法能降低股骨颈手术患者术后切口感染发生率，缩短平均住院日，减少住院费用。? 　　关键词 封闭式负压引流 股骨颈手术 切口感染? 　　doi:10.3969/j.issn.1007-614x.2012.03.129?? 　　Abstract Objective:to study the negative Pressure drainage for femoral neck surgical incision infection influence.Methods:157 cases of femoral neck surgery patients were randomly divided into trial group and control group,the observation group 87 patients after surgery,routine of negative pressure drainage,incision closed aseptic production connected yangzhou negative pressure drainage device,continuous one-time negative pressure drainage about 72 hours;the control group in 70 cases for routine surgery with traditional rubber tube incision natural drainage method.Results:the observation group incision infection rates significantly lower than those of the control group(P＜0.05),the observation group average day in hospital and hospitalization expenses obviously lower than those of the control group(P＜0.01).Conclusion:enclosed the negative pressure drainage than traditional rubber tube natural drainage method can reduce femoral neck surgery patients postoperative incision infection rate,shorten the day in hospital,reduce hospitalization expenses.? 　　Key Words Enclosed the negative Pressure drainage;Femoral neck surgery;Incision infection?? 　　股骨颈骨折是老年人多发常见的一种严重创性伤疾病，尤以老年女性较多。由于老年人骨质疏松，加上老年人伤前疾病多，术后并发症多，护理难度大，若护理不当，可导致手术失败，甚至危及生命。人工股骨头置换术现为治疗老年股骨颈骨折的首选方法。2010年2月～2011年5月收治60岁以上股骨颈骨折患者157例，采用切口持续负压引流替代传统橡皮管自然引流87例，效果??意，现报告如下。? 　　资料与方法? 　　实验组：手术治疗股骨颈骨折患者87例，男35例，女52例，年龄26～77岁。其中车祸伤26例，跌摔伤61例。患者伤后到住院就诊时间0.5～48小时。? 　　对照组：本组70例，男32例，女38例；年龄69～90岁。摔伤50例，车祸伤20例。? 　　手术方法：手术在硬膜外麻或全麻下进行，其中切开复位内固定术64例，人工全髋关节置换术69例，人工股骨头置换术24例。实验组手术结束后，切口硅胶管连接扬州产无菌一次性负压引流器，术后需特别注意观察患肢末端血运、温度及水肿情况，足背搏动强度，发现问题要及时处理。伤口放置封闭式负压引流管，认真观察引流液颜色、性质和流量，注意保持引流