王濤

【摘要】

目的：評價殼聚糖季銨鹽生物膠體液預(yù)防治療闌尾炎手術(shù)切口感染和促進傷口愈合的療效。方法：選取2017年11月至2019年10月在我院普外科治療的急性闌尾炎患者286例。所有患者根據(jù)隨機數(shù)字表法隨機分為殼聚糖季銨鹽生物膠體液組（實驗組，n=143）與對照組（對照組，n=143）。實驗組采用殼聚糖季銨鹽膠體液進行治療，對照組采用碘伏進行治療。在術(shù)后觀察患者的切口愈合情況，并按照有無滲出、開裂、硬結(jié)和紅腫等感染情況對患者進行療效評定，通過切口愈合優(yōu)良率的計算來評價殼聚糖季銨鹽生物膠體液對切口愈合的影響。結(jié)果：實驗組患者的感染、裂開、硬結(jié)、紅腫發(fā)生率均低于對照組，實驗組患者愈合良好率和優(yōu)良率均顯著高于對照組，差異有統(tǒng)計學意義（均P<0.001）。結(jié)論：殼聚糖季銨鹽生物膠體液能夠加快創(chuàng)面自然愈合，患者未留疤痕，值得臨床推廣應(yīng)用。

【關(guān)鍵詞】聚糖季銨鹽生物膠體液;切口愈合;感染

Clinical Summary of Application of Chitosan Quaternary Ammonium Salt Biocolloid Fluid to Prevent Infection and Promote Wound Healing in Postoperative Incisions

Wang Tao （Department of General Surgery， GU Building Hospital， Jiangsu， Nanjing 210008， China）

[Abstract]

Objective：To evaluate the efficacy of chitosan quaternary ammonium salt biocolloid fluid in preventing and treating wound infections and promoting wound healing of appendicitis.

Methods：From November 2017 to October 2019， 286 patients with acute appendicitis were treated in our hospital with general surgery. All patients were randomly divided into the chitosan quaternary ammonium biocolloid fluid group （experimental group， n=143） and the control group （control group， n=143） according to the random number table method.The experimental group was treated with chitosan quaternary ammonium salt colloid fluid， and the control group was treated with iodophor. The wound healing of the patient was observed after the operation， and the curative effect was evaluated according to the presence or absence of infection such as exudation， cracking， induration， and swelling. The chitosan quaternary ammonium biocolloid fluid was evaluated by calculating the excellent rate of wound healing Impact of incision healing. Results：The incidence of infection， dehiscence， induration， and swelling in patients in experimental group were lower than those in the control group. The healing rate and excellent rate of patients in the chitosan quaternary ammonium group were significantly higher than those in the control group. The difference was statistically significant （both P<0.001）. Conclusion：Chitosan quaternary ammonium biocolloid fluid can accelerate the natural healing of wounds without leaving scars in patients， which is worthy of clinical promotion and application.

[Key words]glycan quaternary ammonium biocolloid fluid; wound healing; infection

【中圖分類號】

R715? 【文獻標識碼】

B【文章編號】2095-6851（2020）04-141-02

在外科手術(shù)中切口感染是常見的術(shù)后并發(fā)癥，而腹腔手術(shù)術(shù)后的切口感染的發(fā)病率更高。醫(yī)用殼聚糖季銨鹽生物膠體液是以殼聚糖季銨鹽為原料使用注射用水配制而成膠體液，可以用于各種類型的手術(shù)切口創(chuàng)面修復。普外科中急性闌尾炎是最常見的疾病之一，而手術(shù)切除是治療該疾病的最有效方法。闌尾炎術(shù)后感染是急性闌尾炎手術(shù)最常見的并發(fā)癥，其發(fā)病率為3.0%～21.0%，穿孔性闌尾炎手術(shù)術(shù)后感染的發(fā)病率甚至高達79%。因此，對于闌尾炎手術(shù)術(shù)后切口感染采取有效的預(yù)防治療措施，促進手術(shù)切口愈合具有重要的意義。因此，本研究采用前瞻性臨床對照研究，評價殼聚糖季銨鹽生物膠體液預(yù)防治療闌尾炎手術(shù)切口感染和促進傷口愈合的療效，現(xiàn)報道如下。