双氧水在多节段腰椎术中抗感染及降低术后引流量效果的研究

目的探讨双氧水在多节段腰椎术中抗感染及降低术后引流量的效果。方法回顾性分析2017年1月-2018年1月手术治疗的510例多节段腰椎退行性疾病患者临床资料,其中230例切口缝合前采用双氧水冲洗(研究组),280例采用生理盐水冲洗(对照组)。两组患者性别、年龄、病变类型、病程、手术节段等一般资料比较,差异均无统计学意义(P>0.05)。记录并比较两组患者手术时间、术中出血量、术后引流量及术后感染率,采用美国疾病控制和预防中心(CDC)标准评价感染发生情况。结果两组患者手术时间、术中出血量比较差异无统计学意义(P>0.05),研究组术后引流量明显少于对照组(t=-2.990,P=0.005)。术后13例患者发生感染,其中浅部感染10例(研究组2例、对照组8例),感染持续时间(7.3±1.5)d;深部感染3例(均为对照组患者),感染持续时间(16.6±3.1)d。研究组浅部和深部感染发生率均低于对照组,但差异无统计学意义(χ^2=2.595,P=0.123;P=0.256)。浅部感染均为金黄色葡萄球菌感染,经积极换药后康复;深部感染患者中2例为金黄色葡萄球菌感染、1例为大肠埃希菌感染,均经彻底清洗缝合并积极换药后康复。结论多节段腰椎手术中,切口缝合前使用双氧水冲洗可降低术后感染发生率和术后引流量。

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

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(P>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(P>0.05).The postoperative drainage volume in the study group was significantly less than that in the control group(t=-2.990,P=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(χ^2=2.595,P=0.123;P=0.256).All the superficial infections were Staphylococcus aureus infection and recovered after active dressing change.Among the patients with deep infections,2 cases were infected by Staphylococcus aureus and1 case was infected by Escherichia coli;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.