卡那霉素及多粘菌素B腹腔内保留灌注和切口灌洗预防腹腔和切口感染的疗效观察

目的　探讨多卡液术中腹腔灌注及切口灌洗预防腹腔及切口感染的疗效。方法　 2 4 4例腹部手术患者手术完成缝合腹膜后经腹腔插管一次性灌入多卡液 85 0ml,另 15 0ml缝合腹膜后灌洗浸泡切口 3min后沾干。Ⅱ类手术术后不用任何抗生素 ,Ⅲ类手术术后常规用抗生素 3～ 7d。结果　灌注组 2 4 4例术后腹腔感染 8例 ,感染率 3 3% ;切口感染 10例 ,感染率 4 1%。对照组 2 37例术后腹腔感染 2 6例 ,感染率10 7% ;切口感染 2 8例 ,感染率 10 8%。两组术后感染总数及感染率比较差异显著。结论　多卡液腹部手术时腹腔灌注及切口灌洗能有效预防腹腔及切口感染 ,避免了术后长期使用抗生素预防腹腔和切口感染

Observing the effect on perfusing the abdominal cavity with the solution and washing the incision with it to prevent postoperative infection

Objective To study the effect of perfusing the abdominal cavity with the solution(physiological saline,polymyxin and kananycin) and washing the incision with it to prevent the postoperative infection.Methods First,to perfuse the abdominal cavity with 850ml of the solution through a tube after sewing up the peritoneum,then wash the incision with 150ml of the solution,but three munite later to dry the incision with gauze.It was unnecessary to give any other antibiotic postoperatively if the case was the second type of operation.As to the third type,antibiotics can be given only for 3 to 7 days normally.Results There were 244 cases in the perfused group and 8 of them were infected in the abdominal cavity.The infective rate was 3.3%.And the incision of the 10 cases was infected and the rate was 4.1%.In the control group,26 of the 237 cases were infected in the abdominal cavity and the rate was 10.7%.The incision of 28 cases was infected and the rate was 10.8%.Regarding the infective rate of the two groups,there were significant difference.Conclusion To perfuse the abdominal cavity with the solution of physiological saline,polymyxin and kananycin and wash the incision with it are effective for preventing infection postoperatively and it is not necessary to give antibiotics for a long time.