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[过氧化氢对多节段腰椎手术抗感染及减少术后引流的作用]

[Effect of hydrogen peroxide on anti-infection and reducing postoperative drainage in multi-segmental lumbar surgery].

作者信息

Chen Hao, Yang Junsong, Liu Tuanjiang, Tian Ye, Ding Keyuan, Zhou Yumin, Huang Dageng, Hao Dingjun

机构信息

Department of Spine Surgery, Honghui Hospital Affiliated to Medical School of Xi'an Jiaotong University, Xi'an Shaanxi, 710054, P.R.China;Xi'an Medical University, Xi'an Shaanxi, 710021, P.R.China.

Department of Spine Surgery, Honghui Hospital Affiliated to Medical School of Xi'an Jiaotong University, Xi'an Shaanxi, 710054, P.R.China.

出版信息

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2020 Mar 15;34(3):313-317. doi: 10.7507/1002-1892.201905049.

Abstract

OBJECTIVE

To investigate the effect of hydrogen peroxide on anti-infection and reducing postoperative drainage in multi-segmental lumbar surgery.

METHODS

A clinical data of 510 patients with multi-segmental lumbar degenerative diseases who were treated with surgery between January 2017 and January 2018 was retrospectively analyzed. In study group, the incisions of 230 cases were washed with hydrogen peroxide before suture. In control group, the incisions of 280 cases were washed with normal saline before suture. There was no significant difference in gender, age, lesion type, disease duration, operative segment, and other clinical data between the two groups ( >0.05). The operation time, intraoperative blood loss, postoperative drainage volume, and postoperative incidence of infection were recorded and compared between the two groups. The Centers for Disease Control and Prevention (CDC) standard was used to evaluate infection, which was divided into superficial infection and deep infection.

RESULTS

All operations completed successfully. There was no significant difference in operation time and intraoperative blood loss between the two groups ( >0.05). The postoperative drainage volume in the study group was significantly less than that in the control group ( =-2.990, =0.005). A total of 13 patients developed infection after operation, including 10 cases of superficial infection (2 cases in the study group and 8 cases in the control group) with the infection time of (7.3±1.5) days, and 3 cases of deep infection (all in the control group) with the infection time of (16.6±3.1) days. The incidences of superficial and deep infections in the study group were lower than those in the control group, but there was no significant difference between the two groups ( =2.595, =0.123; =0.256). All the superficial infections were infection and recovered after active dressing change. Among the patients with deep infections, 2 cases were infected by and 1 case was infected by ; and the incisions healed after being washed and sutured thoroughly, and active dressing change.

CONCLUSION

The incidence of postoperative infection and postoperative drainage volume can be reduced by washing the incision with hydrogen peroxide in multi-segmental lumbar surgery.

摘要

目的

探讨过氧化氢在多节段腰椎手术中抗感染及减少术后引流的作用。

方法

回顾性分析2017年1月至2018年1月期间接受手术治疗的510例多节段腰椎退行性疾病患者的临床资料。研究组230例患者在缝合前用过氧化氢冲洗切口。对照组280例患者在缝合前用生理盐水冲洗切口。两组患者在性别、年龄、病变类型、病程、手术节段等临床资料方面差异无统计学意义(>0.05)。记录并比较两组患者的手术时间、术中出血量、术后引流量及术后感染发生率。采用美国疾病控制与预防中心(CDC)标准评估感染情况,分为浅表感染和深部感染。

结果

所有手术均顺利完成。两组患者手术时间和术中出血量差异无统计学意义(>0.05)。研究组术后引流量明显少于对照组(=-2.990,=0.005)。术后共有13例患者发生感染,其中浅表感染10例(研究组2例,对照组8例),感染时间为(7.3±1.5)天,深部感染3例(均在对照组),感染时间为(16.6±3.1)天)。研究组浅表和深部感染发生率均低于对照组,但两组差异无统计学意义(=2.595,=0.123;=0.256)。所有浅表感染均为 感染,经积极换药后痊愈。深部感染患者中,2例为 感染,1例为 感染;经彻底冲洗缝合及积极换药后切口愈合。

结论

多节段腰椎手术中用过氧化氢冲洗切口可降低术后感染发生率及减少术后引流量。

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