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Clinical Application of Continuous Double Perfusion Cannula Accompanied with Negative Pressure Drainage in Abdominal Surgery

目的观察持续冲洗负压引流技术在腹部外科应用的临床效果。方法回顾性分析2006年1月至2011年3月期间我院将自制双套管实施持续冲洗负压引流技术应用于172例腹部外科患者的临床资料。结果全部患者的消化道瘘均治愈，瘘道愈合的平均时间为36 d。治疗过程中，1例患者出现上消化道出血，另1例出现腹腔出血，无腹腔感染、皮肤破溃感染、脓毒症等并发症。结论采用持续冲洗负压引流的双套管制作简单，经济有效，在腹部外科中对术后肠瘘、出血、胆汁漏及感染的防治具有重要临床意义。

生理盐水持续冲洗在封闭式负压引流患者中的护理效果分析

目的　探讨持续生理盐水冲洗在烧伤整形科封闭式负压引流（VSD）患者中的应用效果。 方法　将2012年1月－2013年5月共收集安置VSD装置的65例患者分为对照组与观察组，对照组35例，采用常规持续负压吸引的方法；观察组30例，在常规方法的基础上持续予生理盐水缓慢滴注，冲洗时间为7 d。对两组患者的堵管、漏气、创面修复及术前准备的时间情况进行比较，运用χ2检验与t检验进行统计学分析。 结果　观察组的堵管率、漏气率及术前准备的时间明显小于对照组，创面的修复疗效明显优于对照组，两组差异有统计学意义（Z=−2.241，P＜0.05）。 结论　持续VSD生理盐水冲洗，可以降低堵管及漏气，减少换药的频率，保持创面的清洁，促进肉芽组织生长，尽早的进行自体皮瓣移植的手术，从而缩短术前准备的时间，减轻了患者的痛苦，促进了病床的周转率。

目的 探讨自制双套管持续冲洗负压引流治疗胰腺术后胰瘘的效果。 方法 回顾性分析2008 年 8 月至2014 年3 月期间于笔者所在医院接受自制双套管持续冲洗负压引流治疗的12 例胰瘘患者的临床资料，总 结效果。 结果 12 例患者均接受双套管持续冲洗负压引流治疗，治疗期间引流管若有堵塞，可拔出体外清理。所 有患者均于拔管后治愈。更换双套管早期（1 ～ 3 d）患者发热等感染症状明显缓解，引流10 ～ 22 d 后引流量逐渐 减少。出院后所有患者均获访6 个月，患者恢复良好，胰瘘部位包裹吸收，无并发症发生。 结论 自制双套管持续 冲洗负压引流治疗胰腺术后胰瘘的效果满意，安全可行。

The clinical effect of continuous irrigation and drainage of abdominal cavity in treatment of intestinal fistula combined with abdominal infection

ObjectiveTo explore the clinical efficacy and application significance of continuous irrigation and drainage for intestinal fistula combined with abdominal infection.MethodsClinical data of 62 patients with intestinafistula combined with abdominal infection admitted by Department of General Surgery of The 940th Hospital of The People’s Liberation Army Joint Service Support Force from March 2012 to March 2017 were retrospectively analyzed. All patients were treated with continuous abdominal flushing and drainage after emergency surgery. The duration of peritoneal flushing, antibiotic use, blood picture recovery, fistula healing, and total hospitalization were summarized.ResultsAll 62 patients were treated successfully without death or septic shock. Among them, 49 cases of intestinal fistula were treated with continuous abdominal flushing and drainage, and 13 cases of intestinal fistula were treated by continuous flushing and drainage of the abdominal cavity. There were 6 cases of abdominal abscess, 5 cases of incision infection, 5 cases of pleural effusion, and 2 cases of pulmonary infection after surgery. The continuous abdominal cavity washing time was (45±21) d, antibiotic use time was (14±7) d, blood image recovery time was (16±8) d, the healing time of fistula was (47±24) d, total length of hospital stay was (56±27) d.ConclusionsFor intestinal fistula combined with abdominal cavity infection, peritoneal continuous flushing and drainage is related with curative effect, high cure rate, fewer complications, simple washing equipment, simple technology, lower cost, and convenient nursing, which can create a good condition for the complexity or refractory patients with intestinal fistula, and has a high clinical application significance.