中国实用外科杂志

中国实用外科杂志

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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

黄兴华，胡还章，江    艺   

  1. 南京军区福州总医院肝胆外科，福建福州 350025
  • 出版日期:2016-04-01 发布日期:2016-03-29

  • Online:2016-04-01 Published:2016-03-29

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（P＞0.05）。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。

关键词: 腹部切口, 皮下脂肪层, 持续负压引流, 皮内缝合

Abstract:

Treatment studies of subcutaneous continuous negative pressure drainage during the whole course of incision suture in the abdominal operation        HUANG Xing-hua,HU Huan-zhang, JIANG Yi. Department of Hepatobiliary Surgery，Fuzhou General Hospital of Nanjing Military Command of PLA, Fuzhou 350025,China
Corresponding author: JIANG Yi,E-mail:jiangyi8183@163.com
Abstract    Objective    To discuss the clinical efficacies of subcutaneous continuous negative pressure drainage during the whole course of incision suture in the abdominal operation. Methods    The clinical data of 136 patients performed hepatobiliary-pancreatic operation between July 2014 and March 2015 in Department of Hepatobiliary Surgery, Fuzhou General Hospital of Nanjing Military Command of PLA were analyzed retrospectively. All the patients were divided into Group A and Group B according to the incision suture methods. Group A (n=72) underwent hepatobiliary-pancreatic operation by the whole subcutaneous continuous negative pressure drainage and Group B (n=64) by early extrusion drainage. Suturing time of abdominal wall, situation of incision healing, numbers of postoperative incision liquefaction and postoperative incision split, time of incision  healing, patients’ satisfaction and other indexes were analyzed. Results Suturing time of abdominal wall, incision healing time and patients’ satisfaction in Group A and B were 23(14-30)min, 9(7-15)d,10（5-10）vs. 29(18-42) min,12（8-17）d, 8（4-10） , respectively, and the statistical differences were significant（all P＜0.001）. Numbers of postoperative incision liquefaction and rates of A-grade healing of Group A and B were 3 cases, 94.44% vs. 12 cases, 81.25%, respectively and there were significantly statistical differences（all P＜0.05）. Postoperative incision split occurred in Group A and B occurred in zero and one patients, respectively without statistical difference（P＞0.05）. Conclusion    Skin intradermal suture combined with subcutaneous continuous negative pressure drainage during the whole course of incision suture in the abdominal operation without suturing subcutaneous fat layer plus, can not only shorten operation time, promote incision healing, but also got cosmetic effect, which meets the needs of patients  and is worthy of wide application.

Key words: abdominal incision, subcutaneous fat layer, continuous negative pressure drainage, intradermal suture