采用皮下全程持续负压引流行腹部手术切口缝合疗效研究

发布时间：2018-01-02 15:20

本文关键词：采用皮下全程持续负压引流行腹部手术切口缝合疗效研究　出处：《中国实用外科杂志》2016年04期 　论文类型：期刊论文

【摘要】：目的探讨皮下全程持续负压引流方法进行腹部手术切口缝合的临床疗效。方法回顾性分析2014年7月至2015年3月南京军区福州总医院肝胆外科行肝胆胰手术的136例病人的临床资料。按切口缝合方式不同将病人分为A、B两组,其中A组(72例)采用皮下持续负压引流法,B组(64例)采用早期挤压排液法。分析两组病人腹壁缝合时间、切口愈合情况、切口脂肪液化例数、切口裂开例数、切口愈合时间、病人满意度等指标。结果A、B两组病人腹壁缝合时间、切口愈合时间、病人满意度分别为23(14~30)min、9(7~15)d、10(5~10)分和29(18~42)min、12(8~17)d、8(4~10)分,差异均有统计学意义(P均0.001);A、B两组病人切口液化例数、甲级愈合率分别为3例、94.44%和12例、81.25%,差异均有统计学意义(P均0.05);A、B组病人切口裂开数分别为0例和1例,差异无统计学意义(P0.05)。结论不缝合脂肪层的皮下全程持续负压引流联合皮肤皮内缝合,不仅缩短手术时间,促进切口愈合;而且肌肤美观,满足人们的审美需求,临床上值得推广。
[Abstract]:Objective to investigate the clinical effect of subcutaneous continuous negative pressure drainage method to suture the whole abdominal incision. Methods clinical data of 136 patients were retrospectively analyzed from July 2014 to March 2015, Nanjing General Hospital of Fuzhou Military Department of hepatobiliary surgery for hepatobiliary operation. According to the method of suture of different patients were divided into two groups including A, B, A group (72 cases) by subcutaneous continuous negative pressure drainage method, B group (64 cases) with early extrusion drainage method. Analysis of two groups of patients with abdominal wall suture time, healing of incision, incision fat liquefaction cases, the number of cases of wound dehiscence, wound healing time, patient satisfaction index. Results A, B two groups of patients with abdominal wall suture time and the wound healing time, patient satisfaction was 23 (14~30) min, 9 (7~15) d, 10 (5~10) and 29 (18~42) min, 12 (8~17) d, 8 (4~10), the differences were statistically significant (P 0.001); A, B two groups of patients with incision liquefaction the number of grade a healing Photosynthetic rates were 3, 94.44% and 12 cases, 81.25%, the differences were statistically significant (P 0.05); A, B group of patients with wound dehiscence were 0 cases and 1 cases, the difference was not statistically significant (P0.05). Conclusion the fat layer suture of subcutaneous continuous negative pressure drainage combined with whole skin intradermal suture. Not only shorten the operation time, wound healing; and skin appearance, satisfy people's aesthetic needs, it is worthy of clinical promotion.

【作者单位】：南京军区福州总医院肝胆外科;
【基金】：南京军区医学重大项目(No.14ZX22) 南京军区福州总医院创新团队建设专项资助(No.cxtd005)
【分类号】：R656
【正文快照】： 随着肥胖人群越来越大,腹部手术高频电刀的使用越来越多,腹部手术后切口感染率越来越高。据报道,腹部切口感染占全部腹部手术的9.7%~17.7%[1],占医院感染的13.0%~40.0%[2]。切口愈合不良会延长病人住院时间,加重病人心理和经济负担,降低外科床位周转率,给病人带来很多近期和远

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