中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2014年
23期
31-34
,共4页
急诊处理%全层连续缝合法%分层间断缝合法
急診處理%全層連續縫閤法%分層間斷縫閤法
급진처리%전층련속봉합법%분층간단봉합법
Emergency treatment%Full-thickness continuous suture method%Layer interrupted suture method
目的 评估全层连续缝合法与分层间断缝合法对急诊腹部手术切口愈合的影响.方法 将237例行急诊腹部手术患者按缝合方法不同分为全层连续缝合法组(145例)和分层间断缝合法组(92例),比较两组切口液化和感染发生情况、切口缝合时间等,对发生切口液化和感染患者行细菌培养.结果 全层连续缝合法组切口缝合时间明显短于分层间断缝合法组[(18.37±7.42)min比(25.92±5.79) min],差异有统计学意义(P＜0.01).两组切口液化和感染率、切口Ⅰ期愈合率比较差异无统计学意义(P＞0.05);全层连续缝合法组正中切口的切口液化和感染率低于腹直肌切口[18.58％(21/113)比31.25％(10/32)],切口Ⅰ期愈合率高于腹直肌切口[81.42％(92/113)比68.75％(22/32)],差异有统计学意义(P＜0.05);分层间断缝合法组正中切口和腹直肌切口的切口液化和感染率、切口Ⅰ期愈合率比较差异无统计学意义[33.33％(23/69)比26.09％(6/23)、66.67％(46/69)比73.91％(17/23),P＞0.05];全层连续缝合法组正中切口的切口液化和感染率明显低于分层间断缝合法组正中切口,切口Ⅰ期愈合率明显高于分层间断缝合法组正中切口,差异有统计学意义(P＜0.05),而两组腹直肌切口的切口液化和感染率、切口Ⅰ期愈合率比较差异无统计学意义(P＞0.05).两组发生切口液化和感染患者细菌培养阳性26例,全层连续缝合法组10例(6.90％,10/145),分层间断缝合法组16例(17.39％,16/92),两组比较差异有统计学意义(P＜0.05).感染细菌以大肠埃希菌为主(11例).结论 急诊腹部手术中,正中切口采用全层连续缝合法可以节省时间,降低切口液化和感染率,缝合技术对切口愈合有重要影响.
目的 評估全層連續縫閤法與分層間斷縫閤法對急診腹部手術切口愈閤的影響.方法 將237例行急診腹部手術患者按縫閤方法不同分為全層連續縫閤法組(145例)和分層間斷縫閤法組(92例),比較兩組切口液化和感染髮生情況、切口縫閤時間等,對髮生切口液化和感染患者行細菌培養.結果 全層連續縫閤法組切口縫閤時間明顯短于分層間斷縫閤法組[(18.37±7.42)min比(25.92±5.79) min],差異有統計學意義(P＜0.01).兩組切口液化和感染率、切口Ⅰ期愈閤率比較差異無統計學意義(P＞0.05);全層連續縫閤法組正中切口的切口液化和感染率低于腹直肌切口[18.58％(21/113)比31.25％(10/32)],切口Ⅰ期愈閤率高于腹直肌切口[81.42％(92/113)比68.75％(22/32)],差異有統計學意義(P＜0.05);分層間斷縫閤法組正中切口和腹直肌切口的切口液化和感染率、切口Ⅰ期愈閤率比較差異無統計學意義[33.33％(23/69)比26.09％(6/23)、66.67％(46/69)比73.91％(17/23),P＞0.05];全層連續縫閤法組正中切口的切口液化和感染率明顯低于分層間斷縫閤法組正中切口,切口Ⅰ期愈閤率明顯高于分層間斷縫閤法組正中切口,差異有統計學意義(P＜0.05),而兩組腹直肌切口的切口液化和感染率、切口Ⅰ期愈閤率比較差異無統計學意義(P＞0.05).兩組髮生切口液化和感染患者細菌培養暘性26例,全層連續縫閤法組10例(6.90％,10/145),分層間斷縫閤法組16例(17.39％,16/92),兩組比較差異有統計學意義(P＜0.05).感染細菌以大腸埃希菌為主(11例).結論 急診腹部手術中,正中切口採用全層連續縫閤法可以節省時間,降低切口液化和感染率,縫閤技術對切口愈閤有重要影響.
목적 평고전층련속봉합법여분층간단봉합법대급진복부수술절구유합적영향.방법 장237례행급진복부수술환자안봉합방법불동분위전층련속봉합법조(145례)화분층간단봉합법조(92례),비교량조절구액화화감염발생정황、절구봉합시간등,대발생절구액화화감염환자행세균배양.결과 전층련속봉합법조절구봉합시간명현단우분층간단봉합법조[(18.37±7.42)min비(25.92±5.79) min],차이유통계학의의(P＜0.01).량조절구액화화감염솔、절구Ⅰ기유합솔비교차이무통계학의의(P＞0.05);전층련속봉합법조정중절구적절구액화화감염솔저우복직기절구[18.58％(21/113)비31.25％(10/32)],절구Ⅰ기유합솔고우복직기절구[81.42％(92/113)비68.75％(22/32)],차이유통계학의의(P＜0.05);분층간단봉합법조정중절구화복직기절구적절구액화화감염솔、절구Ⅰ기유합솔비교차이무통계학의의[33.33％(23/69)비26.09％(6/23)、66.67％(46/69)비73.91％(17/23),P＞0.05];전층련속봉합법조정중절구적절구액화화감염솔명현저우분층간단봉합법조정중절구,절구Ⅰ기유합솔명현고우분층간단봉합법조정중절구,차이유통계학의의(P＜0.05),이량조복직기절구적절구액화화감염솔、절구Ⅰ기유합솔비교차이무통계학의의(P＞0.05).량조발생절구액화화감염환자세균배양양성26례,전층련속봉합법조10례(6.90％,10/145),분층간단봉합법조16례(17.39％,16/92),량조비교차이유통계학의의(P＜0.05).감염세균이대장애희균위주(11례).결론 급진복부수술중,정중절구채용전층련속봉합법가이절성시간,강저절구액화화감염솔,봉합기술대절구유합유중요영향.
Objective To assess the influence of full-thickness continuous suture method and layer interrupted suture method in emergency abdominal operation closure.Methods Two hundred and thirtyseven patients of emergency abdominal operation were divided into full-thickness continuous suture method group (145 cases) and layer interrupted suture method group (92 cases) according to the suture method.The rate of incision liquefaction and infection,time of incision suture were compared between the 2 groups,the patients with incision liquefaction and infection were given bacterial culture.Results The time of incision suture in full-thickness continuous suture method group was significantly shorter than that in layer interrupted suture method group [(18.37 ± 7.42) min vs.(25.92 ± 5.79) min],there was statistical difference (P ＜0.01).There were no statistical differences in the rate of incision liquefaction and infection,the rate of incision primary healing between the 2 groups (P ＞ 0.05).In full-thickness continuous suture method group,the rate of incision liquefaction and infection in median incision was significantly lower than that in rectus abdominis incision [18.58％ (21/113) vs.31.25％ (10/32)],the rate of incision primary healing was significantly higher than that in rectus abdominis incision [81.42％ (92/113) vs.68.75％ (22/32)],there were statistical differences (P ＜ 0.05).In layer interrupted suture method group,there were no statistical differences in the rate of incision liquefaction and infection,the rate of incision primary healing between median incision and rectus abdominis incision [33.33％ (23/69) vs.26.09％(6/23),66.67％ (46/69) vs.73.91％ (17/23),P ＞ 0.05].The rate of incision liquefaction and infection in median incision of full-thickness continuous suture method group was significantly lower than that in median incision of layer interrupted suture method group,and the rate of incision primary healing was significantly higher than that in median incision of layer interrupted suture method group,there were statistical differences (P ＜ 0.05).There were no statistical differences in the rate of incision liquefaction and infection,the rate of incision primary healing in rectus abdominis incision between the 2 groups (P ＞ 0.05).The bacterial culture result in patients with incision liquefaction and infection showed positive was in 26 cases,in full-thickness continuous suture method group was in 10 cases (6.90％,10/145),in layer interrupted suture method group was in 16 cases (17.39％,16/92),there was statistical difference (P ＜0.05).The mostly bacterial of infection was Escherichia coli.Conclusions The full-thickness continuous suture in median incision can shorten operative time and reduce the rate of incision liquefaction and infection in emergency abdominal operation.Suture technique has important impact on incision healing.
