Kubota Akio, Goda Taro, Tsuru Tomomitsu, Yonekura Takeo, Yagi Makoto, Kawahara Hisayoshi, Yoneda Akihiro, Tazuke Yuko, Tani Gakuto, Ishii Tomohiro, Umeda Satoshi, Hirano Katsuhisa
Department of Pediatric Surgery, Osaka Medical Center and Research Center for Maternal and Child Health, 840 Murodo-cho, Izumi, Osaka, 594-1101, Japan,
Surg Today. 2015 Jul;45(7):876-9. doi: 10.1007/s00595-014-1050-x. Epub 2014 Nov 13.
Our previous experimental study of perforated peritonitis in rats proved that peritoneal lavage with strong acid electrolyzed water (SAEW) has no adverse effects, reduces the bacteria count in the ascitic fluid more effectively than saline, and increases the survival rate significantly. Thus, we conducted a randomized controlled study, applying SAEW in the treatment of perforated appendicitis in children.
Forty-four patients, aged 3-14 years, were randomly divided into two groups: Group S (n = 20), in which the peritoneal cavity was lavaged with 100 ml/kg saline and the wound was washed out with 200 ml saline; and Group E (n = 24), in which the peritoneal cavity was lavaged with 100 ml/kg SAEW and the wound was washed out with 200 ml SAEW.
No adverse effect of SAEW was observed in Group E. There was no difference in the bacterial evanescence ratio of ascitic fluid after lavage between Groups S and E (11.1 and 15.8%, respectively). A residual abscess developed in one patient from each group (5.0 and 4.2%, respectively). The incidence of surgical site infection (SSI) was significantly lower in Group E than in Group S (0 and 20%, respectively; P < 0.05). There was no difference in the duration of pyrexia, positive C-reactive protein, leukocytosis, or hospital stay between the groups.
Peritoneal lavage and wound washing with SAEW have no adverse effects and are effective for preventing SSI.
我们之前对大鼠穿孔性腹膜炎的实验研究证明,用强酸性电解水(SAEW)进行腹腔灌洗没有不良影响,比生理盐水更有效地降低了腹水细菌计数,并显著提高了存活率。因此,我们进行了一项随机对照研究,将SAEW应用于儿童穿孔性阑尾炎的治疗。
44例年龄在3至14岁的患者被随机分为两组:S组(n = 20),用100 ml/kg生理盐水进行腹腔灌洗,并用200 ml生理盐水冲洗伤口;E组(n = 24),用100 ml/kg SAEW进行腹腔灌洗,并用200 ml SAEW冲洗伤口。
E组未观察到SAEW的不良反应。S组和E组灌洗后腹水细菌消失率无差异(分别为11.1%和15.8%)。每组各有1例患者发生残余脓肿(分别为5.0%和4.2%)。E组手术部位感染(SSI)的发生率显著低于S组(分别为0和20%;P < 0.05)。两组间发热持续时间、C反应蛋白阳性、白细胞增多或住院时间无差异。
用SAEW进行腹腔灌洗和伤口冲洗没有不良影响,对预防SSI有效。