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目的观察皮下持续负压引流对肝癌手术肥胖患者切口脂肪液化和感染的预防控制效果,为临床工作提供依据。方法选取2014年1月-2016年1月医院进行肝癌切除术的100例患者为研究对象,将所有患者随机分为两组,对照组术后接受常规护理,引流组接受皮下持续负压引流,比较两组患者术后脂肪液化及伤口感染的发生率,分析其危险因素。结果引流组的脂肪液化率为2.00%(1/50),伤口感染率为4.00%(2/50);对照组分别为22.00%(11/50)及34.00%(17/50),差异有统计学意义(P<0.05);年龄、术前BMI、糖尿病、高频电刀的使用是患者脂肪液化发生的危险因素,而切口引流是保护因素,相关性具有统计学意义(P<0.05);年龄、术前BMI、糖尿病及低蛋白血症是患者伤口感染发生的危险因素,而切口引流是保护因素,相关性具有统计学意义(P<0.05)。结论皮下持续负压引流可降低肝癌手术肥胖患者切口脂肪液化和感染的发生率。
Objective To observe the effect of subcutaneous sustained negative pressure drainage on prevention and control of fat liquefaction and infection in patients with obesity of liver cancer and to provide basis for clinical work. Methods From January 2014 to January 2016, 100 patients who underwent hepatectomy in the hospital were enrolled in this study. All patients were randomly divided into two groups. The control group received routine nursing after operation, and the drainage group received subcutaneous continuous negative pressure drainage. The incidence of postoperative fat liquefaction and wound infection in both groups were compared and their risk factors were analyzed. Results The rate of fat liquefaction in the drainage group was 2.00% (1/50) and the wound infection rate was 4.00% (2/50) in the drainage group and 22.00% (11/50) and 34.00% (17/50) in the control group, respectively (P <0.05). The use of age, preoperative BMI, diabetes mellitus and high-frequency electric knife was the risk factor of fat liquefaction in patients. However, incision drainage was a protective factor, the correlation was statistically significant (P <0.05) Age, preoperative BMI, diabetes mellitus and hypoproteinemia were the risk factors for wound infection in patients. Incision drainage was a protective factor, and the correlation was statistically significant (P <0.05). Conclusion Subcutaneous continuous negative pressure drainage can reduce the incidence of fat liquefaction and infection in patients with obesity in liver cancer surgery.