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目的评估含银离子抗菌敷贴能否有效降低肝脏术后手术切口感染率。方法采取前瞻性研究方法,对2011年1月至2015年12月在徐州市中心医院肿瘤外科行肝脏手术的患者在手术结束时随机使用含银离子敷贴(含银离子敷贴组,入选105例,退出4例,进入实验101例)和普通无菌纱布(普通无菌纱布组,入选116例,退出6例,进入实验110例)覆盖切口。观察对比两组术后切口愈合情况。结果 110例使用普通无菌纱布的患者中,共有16例出现不同程度的手术切口感染,发生率为14.55%;而101例使用含银离子敷贴的患者中只有5例出现手术切口感染,发生率为4.95%,两组之间差异有统计学意义(P<0.05)。感染手术切口共培养革兰阳性(G+)细菌11株,革兰阴性(G-)细菌10株,其中最常见的是金黄色葡萄球菌。Logistic多因素回归分析显示,年龄>50岁、有糖尿病病史、肝功能B级以及使用普通无菌纱布是外科手术切口感染的独立危险因素(P<0.05,P<0.01)。结论含银离子敷贴可以减少外科手术切口感染的发生率,是一种安全有效的围手术期手术切口护理方式。
Objective To evaluate whether silver ion antibacterial dressing can effectively reduce the surgical incision infection rate after liver surgery. Methods A prospective study was conducted on patients who underwent liver surgery at the Department of Oncology and Surgical Oncology in Xuzhou Central Hospital from January 2011 to December 2015 at the end of surgery. A silver-containing ion-application Cases, withdraw from 4 cases, enter the experiment 101 cases) and ordinary sterile gauze (general sterile gauze group, selected 116 cases, exit 6 cases, enter the experiment 110 cases) covering the incision. Observation and comparison of two groups of incision healing. Results Of the 110 patients who received ordinary sterile gauze, there were 16 cases of surgical incision infection in varying degrees, the incidence rate was 14.55%. Only 5 of 101 patients who applied silver ion-coated wounds developed surgical incision infection, which occurred The rate was 4.95%, the difference between the two groups was statistically significant (P <0.05). Infected surgical incision co-culture of Gram-positive (G +) bacteria 11 strains, Gram-negative bacteria (G-) 10, of which the most common is Staphylococcus aureus. Logistic multivariate regression analysis showed that age> 50 years, history of diabetes mellitus, grade B of liver function and the use of ordinary sterile gauze were independent risk factors for surgical incision infection (P <0.05, P <0.01). CONCLUSION: The silver ion dressing can reduce the incidence of surgical incision infection and is a safe and effective perioperative surgical incision nursing.