改良式皮下负压引流对剖宫产产妇术后腹部切口脂肪液化发生率、切口愈合的影响

目的 探讨改良式皮下负压引流对剖宫产产妇术后腹部切口脂肪液化发生率、切口愈合的影响。方法 104例接受剖宫产手术的产妇随机分为两组各52例,对照组术后给予常规切口缝合处理,观察组术后给予改良式皮下负压引流,比较两组的术后腹部切口脂肪液化发生率及切口愈合情况。结果 观察组的术后切口脂肪液化发生率明显低于对照组,切口愈合优良率及切口面积愈合率均明显高于对照组,切口愈合时间明显短于对照组（P <0.05）。结论 改良式皮下负压引流可明显降低剖宫产产妇术后腹部切口脂肪液化发生率,促进切口愈合。     

化脓性阑尾炎手术切口脂肪层下放置引流对切口愈合的影响观察

目的:分析切口脂肪层下放置引流管对化脓性阑尾炎患者术后切口愈合的影响。方法:本组抽取我院于2011年7月至2013年7月收治的化脓性阑尾炎患者78例,入院后均行手术治疗,将患者随机分为两组,其中对照组患者使用生理盐水冲洗伤口,观察组患者在对照组的基础上于切口脂肪层下放置引流管,观察两组患者切口愈合情况。结果:分析两组患者手术切口情况,观察组患者的切口愈合率明显高于对照组,愈合时间明显低于对照组,差异具有统计学意义(P<0.05)。结论:化脓性阑尾炎患者行手术治疗后,于切口脂肪层下放置引流管,能够提高患者的切口愈合率,值得推广使用。     

负压引流预防术后腹部切口感染的临床分析

目的 探讨一种有效预防严重污染切口感染的措施.方法 回顾性分析1999年12月至2009年12月收治Ⅲ类切口262例患者的临床资料,按简单随机抽样法分为对照组(80例)和研究组(182例):研究组将硅胶管置于腹膜外肌层下及脂肪层下持续负压引流,对照组用常规方法缝合切口.结果 研究组仅3例(1.6%,3/182)切口感染,而对照组14例(17.5%,14/80)切口感染,两组感染率比较差异有统计学意义(P＜0.05).结论 负压引流预防切口感染方法简单有效.     

化脓性阑尾炎手术切口脂肪层下放置引流对切口愈合的影响

目的：分析研究化脓性阑尾炎手术切口脂肪居下放置引流对于患者手术切口愈合的影响。方法：选取2011年i0月到2013年5月的70例化脓性阑尾炎患者资料进行回顾性分析，将70例患者随机分为两组，观察组和对照组各35例，对照组患者使用生理盐水对患者切口给予冲洗，观察组患者在对照组基础之上在患者的切口脂肪层下放置引流，比较观察组和对照组患者的切口恢复状况。结果：观察组患者的手术切口感染几率显著低于对照组患者（P〈0．0i），具有统计学意义，患者的切口拆线时间观察组也低于对照组（P〈0.05），具有统计学意义。结论：针对化脓性阑尾炎手术患者进行手术切口脂肪层下放置引流，能够有效的减少患者的切口感染几率，降低患者的拆线时间，应该在临床中加以推广使用。     

持续负压引流治疗腹部手术后切口感染50例

目的总结持续负压引流治疗腹部手术后切口感染的临床疗效。方法回顾性分析100例腹部切口感染患者,分别采用持续负压引流和常规开放换药治疗,各50例,比较两组切口清洁时间、换药总数、愈合时间。结果持续负压引流组切口清洁时间、换药次数、愈合时间均少于常规开放换药组。结论持续负压引流治疗腹部手术后切口感染愈合快、疗效显著,住院时间短、降低了住院费用,建议腹部手术后切口感染优先选用持续负压引流治疗。     

不同引流方式在腹部手术感染切口治疗中的应用

目的对比分析可冲洗负压封闭引流与传统负压封闭引流在腹部手术感染切口治疗中的应用效果,为临床治疗提供参考依据。方法选取普外科2003年10月-2013年10月收治的76例切口感染患者,将患者随机分为试验组与对照组,各38例;对照组接受传统的负压封闭引流,试验组接受可持续冲洗负压封闭引流,对比分析两组伤口的愈合及负压封闭引流的使用情况。结果共检出病原菌76株,其中革兰阴性菌65株占85.5%,革兰阳性菌11株占14.5%;试验组伤口清洁时间(6.3±1.9)d、伤口换药次数(1.9±0.5)次、伤口愈合时间(15.3±4.2)d,对照组分别为(8.7±1.5)d、(3.1±0.7)次、(19.1±3.7)d,两组比较差异均有统计学意义(P<0.01);试验组负压引流的平均使用时间为(6.5±1.7)d、切口处的细菌计数为(247±158)CFU/cm2,对照组分别为(2.6±1.3)d、(5 318±1 942)CFU/cm2,两组比较差异均有统计学意义(P<0.01)。结论可冲洗负压封闭引流能促进腹部手术感染切口的愈合,减少换药次数,其效果优于传统的负压封闭引流,值得在临床推广应用。     

持续负压密封引流与普通换药治疗骨科手术切口感染的临床疗效分析

目的观察持续负压密封引流(VSD)与普通清创换药在治疗骨科手术切口感染的临床疗效,比较两种方法的优缺点,为临床治疗提供参考。方法收集2011年3月-2013年4月骨科手术切口感染患者共41例,采用随机分组,其中采用VSD治疗的患者(VSD治疗组)21例,采用普通清创换药的患者(普通换药组)20例;通过记录感染切口的清洁时间、愈合时间、切口愈合分级、感染的并发症、疼痛评分及患者满意度,比较VSD与普通换药的疗效。结果 VSD组切口清洁时间为(5±1)d,切口愈合时间为(10±1)d,普通换药组分别为(8±2)d、(14±2)d,两组比较差异有统计学意义(P<0.01);切口愈合分级VSD组甲级95.6%、乙级4.4%,普通换药组甲级81.5%、乙级10.4%、丙级8.10%,两组比较差异有统计学意义(P<0.05);VSD组与普通换药组比较,感染并发症减少,差异有统计学意义(P<0.05),其中VSD治疗组有1例出现术后大量出血,为负压吸引导致血管吻合口破裂所致;VSD组术前和术后VSA疼痛评分差值为(4.86±0.67)分、满意度为(9.85±0.99)分,而普通换药组分别为(2.24±0.77)、(7.21±1.24)分,两组比较差异有统计学意义(P<0.05)。结论持续负压密封引流在骨科手术切口感染与普通换药相比,可减轻患者的痛苦、缩短愈合时间、降低切口感染的并发症、提高患者的满意度。     

低位切口加负压引流在甲状腺癌术中的临床应用分析

目的探讨甲状腺癌根治术手术切口术后美容效果和减少术后切口内积血的方法。方法采用低位长领状切口行甲状腺癌根治术，术后采用负压引流。结果所有病例，术后均未出现积血、积液，切口均甲级愈合，随访无复发、转移，术后颈部戴项链或穿高领衣服，就能基本掩盖手术瘢痕。结论采用低位长领状切口行甲状腺癌根治术，采用负压引流能减少术后切口内积血，术后美容效果极佳，提高了术后生活质量。     

颌面部间隙感染微创切口负压引流的临床治疗研究

目的探讨微创切口联合负压引流治疗颌面部间隙感染的临床效果,以期提高临床治疗水平。方法选取2010年12月-2013年12月95例颌面部间隙感染患者为研究对象,分成对照组46例,予以传统切开手术治疗,观察组49例,予以微创切口联合负压引流治疗,观察两组治疗后临床效果。结果对照组治愈率43.48%、总有效率78.26%,观察组治愈率63.27%、总有效率为91.49%;对照组1~5d拔管占30.43%、>11d拔管占15.22%,1~5d治愈占39.13%、>11d治愈占17.39%;观察组分别占59.18%、4.08%、65.31%、8.16%,两组比较差异有统计学意义(P<0.05);对照组病原菌清除率为93.48%、观察组为95.91%,两组比较差异无统计学意义;两组在皮肤疤痕长、宽度、拔管平均时间、并发症发生种类、白细胞计数恢复时间方面比较,差异有统计学意义(P<0.05)。结论微创切口联合负压引流治疗颌面部间隙感染临床效果显著。     

自制腹壁切口皮下负压引流装置在临床中的应用体会

目的自制腹壁切口皮下负压引流装置(以下简称该装置)在临床中的应用效果。方法 2009—2012年将负压引流导管置于皮下脂肪层的42例患者的临床资料。结果 42例经腹壁切口的患者中,40例患者切口甲级愈合,1例因切口缝线松弛,闭式引流失败而感染。余患者术后7～11d拆线,术后5～20d拔管,感染率约在2.4%,随访0.5～3年切口无裂开无排异反应及切口疝形成。结论该装置能提高腹壁切口甲级愈合率,提高患者恢复期的满意度,且经济、简便易操作,值得临床推广。     

双管负压引流在乳腺癌改良根治术后的应用

目的了解双管负压引流在乳腺癌改良根治术中的作用。方法收集75例接受乳腺癌改良根治术并行双管负压引流患者的临床资料,分析术后皮下积液和皮瓣缺血坏死的情况。结果75例接受乳腺癌改良根治术并行双管负压引流患者手术后发生皮下积液的21例积液量均小于20ml,皮瓣坏死3例均为小范围坏死,全组患者预后理想。结论乳腺癌改良根治术术后应用双管负压引流,可减少皮下积液和皮瓣缺血坏死的发生。     

自制皮下负压引流装置对腹腔术后控制感染的临床研究

目的探讨腹腔术后切口放置自制皮下负压引流装置的应用效果。方法选取医院2016年1月-2017年1月行腹部手术切口愈合不良高危因素患者104例,按随机数字表法分为两组,对照组52例患者,使用普通引流管,试验组52例患者,使用自制皮下负压引流装置,比较两组患者的治疗效果、平均换药次数、平均拆线时间、切口愈合时间及住院时间等指标,比较两组患者术后1~4d引流量,对两组患者术后脂肪液化、切口裂开、切口感染等并发症发生情况进行统计。结果与对照组比较,试验组平均换药次数减少、平均拆线、切口愈合及住院时间均缩短(P0.05);试验组术后第2~4天引流量均低于对照组(P0.05);试验组治疗总有效率高于对照组(P0.05);两组患者术后均有并发症发生。结论在感染性腹腔手术切口防治中,使用自制皮下负压引流装置,不仅可取得良好效果,同时降低术后并发症发生率。     

阿奇霉素不同联合用药方案在宫颈支原体感染的疗效对比

目的比较阿奇霉素不同联合用药方案在宫颈支原体感染的疗效。方法选取2008年12月-2010年12月于本院进行治疗的90例宫颈支原体感染患者为研究对象,将其随机分为A组(阿奇霉素联合安尔碘组)45例和B组(阿奇霉素联合过氧化氢组)45例,后将两组患者的治疗总有效率、转阴率、不良反应发生率、复发率及患者满意率进行统计及比较。结果 A组的总有效率(97.78%)、转阴率(91.11%)及患者满意率(97.78%)高于B组的总有效率(86.67%)、转阴率(73.33%)及患者满意率(88.89%),复发率(4.44%)低于B组(20.00%),差异均有统计学意义(均P<0.05),而两组不良反应发生率均为11.11%,差异无统计学意义。结论阿奇霉素联合安尔碘的疗效优于阿奇霉素联合过氧化氢,在复发率方面也有优势,较受患者欢迎。     

不同厂家牛黄解毒片抑菌作用的比较

目的 根据回收率试验比较不同厂家生产的牛黄解毒片抑菌作用的强弱,确定适宜的微生物限度检查方法.方法 采用微生物限度检查方法,对牛黄解毒片进行方法学验证.结果 不同厂家生产的牛黄解毒片抑菌作用不同,抑菌作用最强的采用离心加薄膜过滤法,同收率＞70.0％.结论 通过对7个厂家生产的牛黄解毒片抑菌作用强弱进行比较,为该品种的微生物限度方法的建立提供参考和依据.     

Screening for cervical cancer among female physicians and their relatives in Taiwan: a population-based comparative study

BACKGROUND: This study compares the practice of having the recommended Pap smear test every 3 years among female physicians, female relatives of physicians, and general women of similar socio-economic background. METHODS: This population-based cohort study followed a total of 5,815,781 Taiwanese women from January 2001 to December 2003, who were 30 years of age or older in 2001. Of the total study population, 1950 were physicians and 27,441 were female relatives of physicians. Multiple logistical regression models were used. RESULTS: After adjusting for age, ethnic status, physical disability status, and place of residence, of those women whose monthly insurable income was greater than $NT 40,000, female physicians (OR 0.54, 95% CI: 0.50-060) were the least likely to have undergone at least one Pap smear test during the three-year study period. The physicians' relatives (OR 0.90, 95% CI: 0.87-0.92) were also significantly less likely to take routine Pap smear tests compared to general women with equivalent socio-economic background. CONCLUSIONS: The female physician is a major player in disease prevention with advanced knowledge of the benefits associated with the Pap smear test, but may not adhere any better to the recommendations than the general population.     

Relative and attributable risk for cervical cancer: a comparative study in the United States and Italy

The attributable risk for invasive cervical cancer in the US and Italian populations has been estimated in relation to main 'aetiological' factors (number of sexual partners, age at first intercourse, parity, oral contraceptive use and smoking) and history of Pap smear using data from two case-control studies conducted in the US (466 cases and 788 controls) and Italy (528 cases and 456 controls). The risk of cervical cancer increased in both studies with multiple sexual partners, decreasing age at first intercourse, higher parity, oral contraceptive use and smoking. Levels of exposure to various risk factors were markedly different in the two countries (ie number of sexual partners, frequency of oral contraceptive use and smoking were greater in the US). Multiple Pap smears and a short interval since last Pap smear strongly reduced risk of cervical cancer in both populations, although screening was much more widespread in the US study population, with only 9% of controls reporting no previous smear versus 38% of the Italian control series. The combined population attributable risk for the five 'aetiological' risk factors was slightly greater in the US study (76%) than in the Italian one (69%), chiefly because of a higher prevalence of exposure to sexual factors in US study women. A substantially larger proportion of Italian cases were due in part to deficiency in screening (46% in US and 84% in Italy). Thus, further inclusion of the effect of screening programmes (number of Pap smears and time since last Pap) led to an overall proportion of cases attributable to the examined risk factors of 87% in the US and 95% in Italy.     

双套管负压持续引流治疗胃肠术后腹腔感染的临床研究

目的探讨双套管负压持续引流治疗胃肠术后腹腔感染的临床效果,以期提高临床治疗水平。方法以2011年3月-2013年1月90例胃肠术后腹腔感染患者为研究对象,平均分为两组,对照组45例予以传统的乳胶引流,观察组45例则予以双套管负压持续引流治疗,比较两组治疗后的效果情况;采用SPSS13.0软件进行分析。结果共检出病原菌36株,对照组24株占66.67%,观察组12株占33.33%;其中对照组、观察组均以金黄色葡萄球菌为主分别占33.33%、13.89%,其次为大肠埃希菌、鲍氏不动杆菌、肺炎克雷伯菌、真菌;引流液变清时间、拔管时间、置管时间、住院时间、平均引流量、二重感染率观察组分别为(5.53±1.83)d、(9.54±4.68)d、(10.28±4.36)d、(17.95±8.58)d、(158.94±23.74)ml/d、2.22%,对照组分别为(7.64±2.23)d、(15.82±6.63)d、(14.84±5.37)d、(23.78±1.85)d、(100.45±17.46)ml/d、11.11%,两组比较差异有统计学意义(P<0.05)。结论双套管负压持续引流能减少胃肠术后腹腔感染的发生率,缩短引流时间,临床效果满意。     

Incidence of cervical cancer following negative smear. A cohort study from Maribo County, Denmark

In order to estimate the risk of developing cervical cancer among women who originally had cytologically normal Papanicolaou (Pap) smears, information has been collected on all Pap smears taken in Maribo County, Denmark in 1966-1982 among women born 1918-1952. A total of 27,811 women are included in the study, and cases of invasive cervical cancer developed in the study population have been identified from the local department of pathology and from the Danish Cancer Registry. The incidence of cervical cancer has been tabulated by number of previous negative smears and by time elapsed since last negative smear. Women with one previous negative smear have a zero risk of developing cervical cancer during the first year following the negative smear. The incidence among these women increases with length of time since the negative smear and reaches the level of unscreened women during the fifth year of follow-up. Women with 2-4 previous negative smears also have a negligible risk of developing cervical cancer during the first two years following the last negative smear. The incidence among these women increases less over time than the incidence for women with one previous negative smear. No cases of cervical cancer were observed among 7,716 women with 5+ previous negative smears. The study indicates that the 5-year risk of developing cervical cancer is 48% lower in women with one previous negative smear than in an unselected population of unscreened women. The 5-year risk for women with 2-4 previous negative smears is 69% lower than that for unscreened women.