腹腔引流液监测对一次性引流袋更换时间影响探讨
[摘 要]目的 探讨腹部手术后腹腔引流一次性引流袋更换的适宜时间。方法 对照组30例，每日按照无菌操作方法更换一次性引流袋；观察组40例，于术后当日(置管24 h)、第3日更换一次性引流袋，两组均分别于置管24 h、第3天更换一次性引流袋时，取腹腔引流管内侧与引流袋接头处及引流袋内引流液做细菌培养监测。结果 置管24 h，腹腔引流管内侧与引流袋接头处引流液的细菌培养阳性率对照组为3.3%，观察组为2.6%，引流袋内引流液的细菌培养阳性率对照组与观察组均为0；置管3 d腹腔引流管内侧与引流袋接头处引流液的细菌培养阳性率对照组为8.1%,观察组为14.2%,引流袋内引流液细菌培养阳性率对照组为6.7%，观察组为15%。两组比较，均无显著性差异(P>0.05)。结论 在临床护理工作中，频繁的更换引流袋容易增加细菌污染的机会，间断更换引流袋并没有提高细菌阳性率，一次性引流袋的更换时间可以每3 d天更换1次。
[关键词] 腹腔引流；引流液；引流袋；更换时间；细菌监测
[中图分类号] R472[文献标识码] A[文章编号] 1672-4208(2008)01-0019-02
To Investigate the Replacing Time of Drainage Pack for Monitoring the Liquid from Abdominal Cavity LIU Songxia.The General Surgery.the People's Hospital of Linyi, Linyi276002,China
【Abstract】 Objective To investigate more suitable replacing time of drainage pack in the postoperative patients with intraperitoneal drainage.
Methods In the control group , the drainage packs of 30 patients were replaced every day. In the experimental group , The drainage packs of 40 patients were replaced on the first day and the third day.Thebacterial cultureof the liquid which was collected from the connectors of drainage packs and tubes , the drainage packs and the drainage tubes was carried out on the first day and the third day.
Results In the control group , The positive rate of bacterial culture of the liquid which was collected from the drainage tubes and the connectors of drainage packs and tubes being carried out on the first day was 3.3% , and it was 2.6% in the experimental group.The positive rate of bacterial culture of the liquid which was collected from the drainage packs being carried out on the first day was zero in the both groups. In the control group , the positive rate of bacterial culture of the liquid which was collected from the drainage tubes and the connectors of drainage packs and tubes being carried out on the third day was 8.1%. It was 14.2% in the experimental group. The positive rate of bacterial culture of the liquid which was collected from the drainage packs being carried out on the third day was 6.7% in the control group, and it was 15%.There is no difference between two groups (P>0.05).
Conclusion Replacing drainage packs frequently increases the chance bacterial contamination.The bacterial positive rate is not raised with replacing drainage packs for long. The drainage pack can be replaced every 3 days.
【Key words】 Intraperitoneal drainage；Drainage pack；Replacing time；Monitoring bacterium
一次性引流袋已广泛应用于临床，科学合理的应用引流袋可以有效的预防逆行感染，便于医护人员观察病情，提高医疗护理质量。为进一步探讨腹部手术后置引流管连接一次性引流袋者更换一次性引流袋的最佳时间，笔者对70例不同时间更换引流袋引流管内侧与引流袋接头处(管袋接头处)及引流袋内的腹腔引流液各种细菌菌落进行了监测，现报告如下。
1 资料与方法
1.1 一般资料 70例患者均为2007年1月至6月在我院行腹部手术，术后行腹腔引流者。其中胰腺占位者14例，直肠癌20例,胆石症16例,胃癌12例，结肠癌8。将患者随机分为两组，观察组40例，对照组30例。两组疾病种类、病人年龄无显著差异，且均排除手术前已经发生腹腔感染。
1.2 实验材料 采用常州晓春医疗器材有限公司生产的一次性使用体外引流袋。灭菌时间均在有效期内。
1.3 方法
1.3.1 标本采集 对照组每日按照无菌操作方法更换一次性引流袋，并于术后24 h、第3日换袋时分别采集管袋接头处及引流袋内引流液作细菌培养。观察组于术后24 h、第3日更换1次性引流袋，换袋时分别采集管袋接头处及引流袋内引流液作细菌培养。
1.3.2 实验要求 标本的采集均由科研小组成员严格按照无菌操作的要求取样，腹腔引流管与引流袋接头处用0.5%碘伏消毒后分离取样,消毒范围大于2.5 cm；引流袋用0.5%碘伏消毒(直径大于5 cm)后，用5 ml无菌空针抽取2 ml引流液做细菌培养。, 百拇医药(刘松霞)
[关键词] 腹腔引流；引流液；引流袋；更换时间；细菌监测
[中图分类号] R472[文献标识码] A[文章编号] 1672-4208(2008)01-0019-02
To Investigate the Replacing Time of Drainage Pack for Monitoring the Liquid from Abdominal Cavity LIU Songxia.The General Surgery.the People's Hospital of Linyi, Linyi276002,China
【Abstract】 Objective To investigate more suitable replacing time of drainage pack in the postoperative patients with intraperitoneal drainage.
Methods In the control group , the drainage packs of 30 patients were replaced every day. In the experimental group , The drainage packs of 40 patients were replaced on the first day and the third day.Thebacterial cultureof the liquid which was collected from the connectors of drainage packs and tubes , the drainage packs and the drainage tubes was carried out on the first day and the third day.
Results In the control group , The positive rate of bacterial culture of the liquid which was collected from the drainage tubes and the connectors of drainage packs and tubes being carried out on the first day was 3.3% , and it was 2.6% in the experimental group.The positive rate of bacterial culture of the liquid which was collected from the drainage packs being carried out on the first day was zero in the both groups. In the control group , the positive rate of bacterial culture of the liquid which was collected from the drainage tubes and the connectors of drainage packs and tubes being carried out on the third day was 8.1%. It was 14.2% in the experimental group. The positive rate of bacterial culture of the liquid which was collected from the drainage packs being carried out on the third day was 6.7% in the control group, and it was 15%.There is no difference between two groups (P>0.05).
Conclusion Replacing drainage packs frequently increases the chance bacterial contamination.The bacterial positive rate is not raised with replacing drainage packs for long. The drainage pack can be replaced every 3 days.
【Key words】 Intraperitoneal drainage；Drainage pack；Replacing time；Monitoring bacterium
一次性引流袋已广泛应用于临床，科学合理的应用引流袋可以有效的预防逆行感染，便于医护人员观察病情，提高医疗护理质量。为进一步探讨腹部手术后置引流管连接一次性引流袋者更换一次性引流袋的最佳时间，笔者对70例不同时间更换引流袋引流管内侧与引流袋接头处(管袋接头处)及引流袋内的腹腔引流液各种细菌菌落进行了监测，现报告如下。
1 资料与方法
1.1 一般资料 70例患者均为2007年1月至6月在我院行腹部手术，术后行腹腔引流者。其中胰腺占位者14例，直肠癌20例,胆石症16例,胃癌12例，结肠癌8。将患者随机分为两组，观察组40例，对照组30例。两组疾病种类、病人年龄无显著差异，且均排除手术前已经发生腹腔感染。
1.2 实验材料 采用常州晓春医疗器材有限公司生产的一次性使用体外引流袋。灭菌时间均在有效期内。
1.3 方法
1.3.1 标本采集 对照组每日按照无菌操作方法更换一次性引流袋，并于术后24 h、第3日换袋时分别采集管袋接头处及引流袋内引流液作细菌培养。观察组于术后24 h、第3日更换1次性引流袋，换袋时分别采集管袋接头处及引流袋内引流液作细菌培养。
1.3.2 实验要求 标本的采集均由科研小组成员严格按照无菌操作的要求取样，腹腔引流管与引流袋接头处用0.5%碘伏消毒后分离取样,消毒范围大于2.5 cm；引流袋用0.5%碘伏消毒(直径大于5 cm)后，用5 ml无菌空针抽取2 ml引流液做细菌培养。, 百拇医药(刘松霞)