壳聚糖季铵盐生物胶体液应用于术后切口预防感染和促进伤口愈合临床总结

王涛

【摘要】

目的：评价壳聚糖季铵盐生物胶体液预防治疗阑尾炎手术切口感染和促进伤口愈合的疗效。方法：选取2017年11月至2019年10月在我院普外科治疗的急性阑尾炎患者286例。所有患者根据随机数字表法随机分为壳聚糖季铵盐生物胶体液组（实验组，n=143）与对照组（对照组，n=143）。实验组采用壳聚糖季铵盐胶体液进行治疗，对照组采用碘伏进行治疗。在术后观察患者的切口愈合情况，并按照有无渗出、开裂、硬结和红肿等感染情况对患者进行疗效评定，通过切口愈合优良率的计算来评价壳聚糖季铵盐生物胶体液对切口愈合的影响。结果：实验组患者的感染、裂开、硬结、红肿发生率均低于对照组，实验组患者愈合良好率和优良率均显著高于对照组，差异有统计学意义（均P<0.001）。结论：壳聚糖季铵盐生物胶体液能够加快创面自然愈合，患者未留疤痕，值得临床推广应用。

【关键词】聚糖季铵盐生物胶体液;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

【中圖分类号】

R715  【文献标识码】

B【文章编号】2095-6851（2020）04-141-02

在外科手术中切口感染是常见的术后并发症，而腹腔手术术后的切口感染的发病率更高。医用壳聚糖季铵盐生物胶体液是以壳聚糖季铵盐为原料使用注射用水配制而成胶体液，可以用于各种类型的手术切口创面修复。普外科中急性阑尾炎是最常见的疾病之一，而手术切除是治疗该疾病的最有效方法。阑尾炎术后感染是急性阑尾炎手术最常见的并发症，其发病率为3.0%～21.0%，穿孔性阑尾炎手术术后感染的发病率甚至高达79%。因此，对于阑尾炎手术术后切口感染采取有效的预防治疗措施，促进手术切口愈合具有重要的意义。因此，本研究采用前瞻性临床对照研究，评价壳聚糖季铵盐生物胶体液预防治疗阑尾炎手术切口感染和促进伤口愈合的疗效，现报道如下。