创面应用生理盐水冲洗量与细菌残留量相关临床研究

目的:探讨创面应用生理盐水冲洗量与细菌残留量的关系。方法:随机选择31例因外伤需清创的病人,伤口深度均达到或超过真皮层。常规麻醉,测量伤口面积,确定采样的创面组织。冲洗前创面采样、每平方厘米创面用生理盐水30ml、40ml、50ml、60ml、70ml、80ml、110ml,在相同条件下冲洗,冲洗完毕,分别做创面采样。依次均分为8组,做细菌培养。结果:统计学处理显示:第1～7组之间存在极显著性差异(P≤0.01),第8组与第1～6组之间存在极显著性差异(P≤0.01),而第8组与第7组之间差异无显著性(P>0.05)。均数比较显示冲洗量与细菌残留量的变化关系:在冲洗量50-60ml/cm2之间存在拐点,在此之前细菌残留量随冲洗量的增加而显著减少,在此之后,随冲洗量的增加冲洗量的增加,细菌残留量的减少不显著。因此,50～60ml/cm2为经济冲洗量。当冲洗量大于等于80ml/cm2时,随着冲洗量增加,细菌残留数量无差异变化,该冲洗量是统计学意义上的无差别冲洗量。结论:按照冲洗量宁多勿少的原则,认为在此条件下的清创术中,使用生理盐水冲洗创面的合适用量(或不得少于)50～60ml/cm2,超过80ml/cm2则无意义。

Clinical research on relationship of saline flushing dose and bacterial residue on wound surface

Objective:To give an optimum volume of saline flushing dose in debridement due to bacterial residue on wound. Methods:31 patients were chosen randomly, who needed debridements on or deeper than corium layer. After conventional anaesthesia, wound extent were measured and sample tissues are chosen. Then on the same condition, saline of 30ml, 40ml, 50ml, 60ml, 70ml, 80ml and 110ml per column centimetre were used to flush the sample tissues respectively. Samples were grouped to eight according saline flushing d...