CHG抗菌透明敷料联合吸收性明胶海绵在癌性腹水患者腹腔穿刺拔管后渗液中的应用效果

目的 探讨葡萄糖酸氯己定（CHG）抗菌透明敷料联合吸收性明胶海绵在癌性腹水患者腹腔穿刺拔管后渗液护理中的应用效果。 方法 选择2022年3月至2023年2月南京医科大学附属明基医院收治的120例癌性腹水患者，根据随机数字表法将其分为对照组和试验组，每组60例。对照组采用普通敷料联合吸收性明胶海绵填塞穿刺点护理，试验组采用CHG抗菌透明敷料联合吸收性明胶海绵填塞穿刺点护理。观察两组拔管后72 h穿刺点感染及红肿情况、拔管后24 h渗液情况、拔管后72 h伤口换药频次及卫生经济学指标。 结果 试验组拔管后72 h的穿刺点感染发生率低于对照组，且穿刺点红肿面积小于对照组，差异有统计学意义（P＜0.05）。试验组拔管后24 h渗液少于对照组，差异有统计学意义（P＜0.05）。试验组拔管后72 h换药频次少于对照组，差异有统计学意义（P＜0.05）。试验组敷料成本高于对照组，穿刺点感染治疗成本、皮肤红肿治疗成本低于对照组，差异有统计学意义（P＜0.05）。两组总成本比较，差异无统计学意义（P＞0.05）。 结论 CHG抗菌透明敷料联合吸收性明胶海绵填塞穿刺点护理能够减轻癌性腹水患者腹腔穿刺拔管后渗液、穿刺点感染及红肿，减少换药频次，卫生经济学效益与普通敷料联合吸收性明胶海绵填塞穿刺点相当。

Application effect of CHG antibacterial transparent dressing combined with absorbent gelatin sponge on exudation after abdominal puncture in patients with cancerous ascites

Objective To investigate the application effect of chlorhexidine gluconate (CHG) antibacterial transparent dressing combined with absorbent gelatin sponge in the care of patients with cancer ascites after abdominal puncture and extubation. Methods A total of 120 patients with cancerous ascites admitted to Mingji Hospital Affiliated to Nanjing Medical University from March 2022 to February 2023 were selected and divided into control group and experimental group according to random number table method, with 60 cases in each group. The control group was treated with common dressing combined with absorbable gelatin sponge, and the experimental group was treated with CHG antibacterial transparent dressing combined with absorbable gelatin sponge. The infection and swelling of puncture site 72 h after extubation, fluid seepage 24 h after extubation, wound dressing change frequency 72 h after extubation, and health economics indexes were observed. Results 72 h after extubation, the incidence of puncture site infection in experimental group was lower than that in control group, and the redness area of puncture sitein experimental group was smaller than that in control group, the differences were statistically significant (P＜0.05). The fluid seepage in experimental group was less than that in control group 24 h after extubation, and the difference was statistically significant (P＜0.05). The frequency of dressing change 72 h after extubation in experimental group was less than that in control group, and the difference was statistically significant (P＜0.05). The dressing cost of experimental group was higher than that of control group, and the treatment cost of puncture site infection and skin swelling was lower than that of control group, and the differences were statistically significant (P＜0.05). There was no significant difference in total cost between two groups (P＞0.05). Conclusion CHG antibacterial transparent dressing combined with absorbable gelatin sponge can reduce the seepage, infection and redness of the puncture point after extubation of abdominal cavity in patients with cancer ascites, reduce the frequency of dressing change, and the health and economic benefits are equivalent to that of common dressing combined with absorbable gelatin sponge.