摘要
目的:比较不同包皮环切术术后感染率并分析长效抗菌剂的预防效果,为继发性感染预防和控制工作提供客观依据。方法:选取2017年8月~2018年3月包茎及包皮过长170例患者,其中,应用传统包皮环切术患者50例作为A组,应用一次性包皮切割缝合器有120例作为B组。将A组患者随机分为A1组和A2组,每组各25例,A1患者在包扎前及每次更换敷料时在创面喷洒长效抗菌剂。对A、B两组患者的术中出血量、手术时间、切口创面愈合时间、术后1h和7d的视觉模拟量表(VAS)评分及术后切口感染、水肿、出血等并发症发生率进行观察和对比;对A1组和A2组患者的术后切口感染率及切口分泌物样本中的病原菌分布进行观察和对比。结果:A组患者的术中出血量、手术时间、术后1h VAS评分、术后7d VAS评分均显著高于B组,两组之间的差异均有统计学意义;A组患者的术后切口感染的发生率为24%,显著高于B组的1.67%,差异有统计学意义;A1组和A2组患者的术后切口感染率分别为12%和36%,差异有统计学意义。在A1组和A2组术后感染患者的切口分泌物样本分别检出6株和12株病原菌,在A1组检出的病原菌中,革兰阴性菌2株占33.33%,革兰阳性菌3株占50%,真菌1株占16.67%,在A2组检出的病原菌中,革兰阴性菌7株占58.33%,革兰阳性菌3株占25%,真菌2株占16.67%,两组检出病原菌的构成比差异有统计学意义。结论:相对于应用传统包皮环切术,应用一次性包皮环切缝合器可缩短手术时间、减少术中出血量、减轻术后疼痛程度、降低术后感染率,对于传统包皮环切术患者局部应用长效抗菌剂,能够减少革兰阴性病原菌的构成比,降低术后切口感染率。
Objective To compare the infection rates between the patients treated with different types of phimosiectomy and analyzed the preventive effects of Long-Acting Antimicrobial Material to provide an objective basis for the prevention and control of secondary infections.Methods 170 cases of patients with capistration or redundant prepuce from August of 2017 to March of 2018 were selected,in which,50 cases treated with tradtional phimosiectomy were selected as group A,120 cases treated with the one time phimosiectomy seaming device were selected as group B.The patients in group A were randomly divided into group A1 and group A2,25 cases were included into each group.The patients in group A1 were sprayed with the Long-Acting Antimicrobial Material before dressing and at each time of dressing changing.The intraoperative bleeding amount,the operation time,the wound healing time,the Visual Analog Scale(VAS)scores at 1h and 7d after the operations and the incidences of the postoperative complications such as infections,edema,bleeding between the patients in group A and group B were observed and compared.The incidences of the postoperative incision infections and the distribution of hte pathogenic bacteria in the incision exudate samples between the patients in group A1 group and group A2 were observed and compared.Results The intraoperative bleeding amount,the operation time,the VAS scores at 1h and 7d after the operations of the patients in group A were significantly higher than those in group B,and the differences between the two groups were statistically significant;The incidences of the postoperative incision infections of the patients in group A was 24%,which was significantly higher than 1.67%in group B,the difference was statistically significant;The incidences of the postoperative incision infections of the patients in group A1 and group A2 were 12%and 36%,the difference was statistically significant.In group A1 and group A2,6 and 12 pathogenic bacteria were detected.In group A1,2 were Gram-negative bacteria accoun
作者
李强
Li Qiang(Department of Urology,Second Hospital of Qinhuangdao City,Qinhuangdao 066600,China)
出处
《湖南师范大学学报（医学版）》
2020年第2期171-175,共5页
Journal of Hunan Normal University(Medical Sciences)
关键词
包皮环切术
术后感染
长效抗菌剂
预防
phimosiectomy
postoperative infection
long-acting antimicrobial material
prevention
