中国社区医师
中國社區醫師
중국사구의사
Chinese Community Doctors
2014年
11期
73-74,75
,共3页
妇产科%下腹部横切口%皮下脂肪%皮内缝合%切口甲级愈合%分层撕开
婦產科%下腹部橫切口%皮下脂肪%皮內縫閤%切口甲級愈閤%分層撕開
부산과%하복부횡절구%피하지방%피내봉합%절구갑급유합%분층시개
Obstetrics and Gynecology Department%Lower abdominal transverse incision%Subcutaneous fat%Intradermal suture%Class-A healing of incision%Hierarchical tearing
目的：观察妇产科下腹部横切口分层撕开法开腹及皮下脂肪不縫合切口愈合情况，以改进妇产科下腹部横切口手术方法及缝合技术，减少下腹部横切口愈合不良，甚至感染。方法：收治妇产科下腹部横切口手术患者1560例，随机分为两组，观察组900例采用分层撕开法开腹及皮下脂肪不縫合，直接用4-0的可吸收线皮内连续缝合，对照组660例采用常规分层开腹，先缝合皮下脂肪，再用4-0的可吸收线皮内连续缝合。结果：两组不受年龄、切口处脂肪厚度、切口长度和下腹部横切口陈旧瘢痕的影响，观察组下腹部横切口手术时间、出血量、甲级愈合率、切口愈合时间、脂肪液化、切口感染、皮下硬结、术后发热症状构成比、平均住院时间、平均资源消耗、群众满意度调查结果均较对照组明显优化。切口部分裂开的50例中采用二期缝合、蝶型胶布牵拉对合，其愈合率达100%。结论：妇产科下腹部横切口分层撕开法开腹及皮下脂肪不缝合，脂肪液化少，甲级愈合率高，硬结少，愈合后呈线状，手术时间短，节约资源，住院时间短，平均住院费用低，群众满意高，医疗纠纷少，简单，易学，安全，深受广大医生的青睐。
目的：觀察婦產科下腹部橫切口分層撕開法開腹及皮下脂肪不縫閤切口愈閤情況，以改進婦產科下腹部橫切口手術方法及縫閤技術，減少下腹部橫切口愈閤不良，甚至感染。方法：收治婦產科下腹部橫切口手術患者1560例，隨機分為兩組，觀察組900例採用分層撕開法開腹及皮下脂肪不縫閤，直接用4-0的可吸收線皮內連續縫閤，對照組660例採用常規分層開腹，先縫閤皮下脂肪，再用4-0的可吸收線皮內連續縫閤。結果：兩組不受年齡、切口處脂肪厚度、切口長度和下腹部橫切口陳舊瘢痕的影響，觀察組下腹部橫切口手術時間、齣血量、甲級愈閤率、切口愈閤時間、脂肪液化、切口感染、皮下硬結、術後髮熱癥狀構成比、平均住院時間、平均資源消耗、群衆滿意度調查結果均較對照組明顯優化。切口部分裂開的50例中採用二期縫閤、蝶型膠佈牽拉對閤，其愈閤率達100%。結論：婦產科下腹部橫切口分層撕開法開腹及皮下脂肪不縫閤，脂肪液化少，甲級愈閤率高，硬結少，愈閤後呈線狀，手術時間短，節約資源，住院時間短，平均住院費用低，群衆滿意高，醫療糾紛少，簡單，易學，安全，深受廣大醫生的青睞。
목적：관찰부산과하복부횡절구분층시개법개복급피하지방불봉합절구유합정황，이개진부산과하복부횡절구수술방법급봉합기술，감소하복부횡절구유합불량，심지감염。방법：수치부산과하복부횡절구수술환자1560례，수궤분위량조，관찰조900례채용분층시개법개복급피하지방불봉합，직접용4-0적가흡수선피내련속봉합，대조조660례채용상규분층개복，선봉합피하지방，재용4-0적가흡수선피내련속봉합。결과：량조불수년령、절구처지방후도、절구장도화하복부횡절구진구반흔적영향，관찰조하복부횡절구수술시간、출혈량、갑급유합솔、절구유합시간、지방액화、절구감염、피하경결、술후발열증상구성비、평균주원시간、평균자원소모、군음만의도조사결과균교대조조명현우화。절구부분렬개적50례중채용이기봉합、접형효포견랍대합，기유합솔체100%。결론：부산과하복부횡절구분층시개법개복급피하지방불봉합，지방액화소，갑급유합솔고，경결소，유합후정선상，수술시간단，절약자원，주원시간단，평균주원비용저，군음만의고，의료규분소，간단，역학，안전，심수엄대의생적청래。
Objective:To observe the wound healing of lower abdominal transverse incision hierarchical tearing method and subcutaneous fat without suture in obstetrics and gynecology department in order to improve the lower abdominal transverse incision operation method and technique of suture in obstetrics and gynecology department,reduce poor healing of lower abdominal transverse incision and even infection.Methods:1560 operation patients with lower abdominal transverse incision were selected,they were randomly divided into two groups.900 cases of the observation group were treated by hierarchical tearing method and subcutaneous fat without suture,using intracutaneous continuous suture with 4-0 absorbable line.660 cases in the control group were treated with conventional layered open.First of all,the subcutaneous fat was sutured,then we took the intracutaneous continuous suture with 4-0 absorbable suture.Results:Effects of two groups were not affected by age,incision fat thickness,length of incision,and old scars of lower abdominal transverse incision.In the observation group,lower abdominal transverse incision operation time,bleeding volume,class-A healing rate,healing time of incision,fat liquefaction,incision infection, subcutaneous induration,postoperative fever symptoms constitute ratio,average hospitalization time,the average consumption of resources,the masses satisfaction were significantly better than the control group.50 cases with partial dehiscence of incision were treated by secondary suture and pulled on with butterfly type tape,the healing rate was 100%.Conclusion:Using ower abdominal transverse incision hierarchical tearing method and subcutaneous fat without suture in obstetrics and gynecology department has many advantages,such as less fat liquefaction,higg class-A healing rate,less induration,be linear after healing,short operation time, saving resources,shorter hospital stay,low average hospitalization expenses,high masses satisfaction,less medical dispute,simple, easiness,safe,and it is well received by the doctor's favour.
