术中及术后短时静脉给氧对腹部污染手术切口的影响

目的探讨手术中、手术后短时静脉给氧疗法对腹部污染手术切口感染的影响.方法2004年3月至2005年12月行腹部污染手术100例,随机分组.手术开始至术后2h内观察组(50例)用静脉给氧(使用舒氧灵)方式供氧(FiO299.5%),对照组(50例)用鼻导管供氧(FiO228%).术后2h抽股动脉血测定血气分析,均测定末梢动脉血氧饱和度,记录有无氧中毒表现.观察切口至术后15d,切口丙级愈合为切口感染.结果两组均无氧中毒表现.术后2h动脉血气分析,观察组PaO2为(175.1±37.9)mmHg,对照组PaO2为(110.2±29.2)mmHg,两组比较P＜0.001.术后末梢动脉血氧饱和度两组均正常.观察组切口感染3例(6.0%),对照组9例(18.0%),两组比较P＜0.05.结论手术中、手术后短时静脉给氧疗法可减少腹部污染手术切口感染.

Effect of supplemental peri-and post-operative oxygen on abdominal contaminated wound infection.

Objective To explore the effect of peri-and post-operative administration of supplemental oxygen on abdominal contaminated surgical wound infection. Methods From Aarch 2004 to December 2005- 100 patients undergoing abdominal contaminated operation were randomly divided into two groups to receive FiO299.5%(n=50- study group) or FiO228%(n=50- control group) inspired oxygen during the operation and two hours postoperatiyely. The partial pressure of oxygen in arterial blood and the peripheral arterial oxygen saturation was measured within two hours after operation. During postoperative 15 days- the wounds with drained pus were considered to be infected. Results The results showed that the partial pressure of oxygen in arteral blood in study group was significantly higher than that in control group(P<0.001) and the peripheral arterial oxygen saturation was normal in both groups. Three(6.0%) patients receiving 99.5% Oxygen had surgical wound infection- as compared with 9(18.0%) patients receiving 28% Oxygen(P<0.05). Conclusions Supplemental peri-and post-operative Oxygen can reduce the incidence of abdominal contaminated surgical wound infection.