皮下置双腔管负压引流在腹部Ⅲ类切口手术中的应用  

Insertion of Double-lumen Tube with Suction Drainage under Skin for Abdominal Incision of Type Ⅲ

作　　者：崔文军[1] 付聿铭[1] 

机构地区：[1]郑州大学第五附属医院普外一科,郑州市450052

出　　处：《医药论坛杂志》2009年第8期12-13,16,共3页Journal of Medical Forum

摘　　要：目的探讨运用皮下置双腔管负压引流对腹部Ⅲ类手术切口感染的预防作用和临床应用价值。方法对腹部手术Ⅲ类切口的患者200例,随机分为实验组100例常规间断全层缝合腹膜及腱膜肌层,皮下置双腔管负压引流,间断缝合皮肤及皮下组织。对照组100例,常规间断全层缝合腹膜及腱膜肌层,全层缝合皮肤及皮下组织。对两组患者年龄大于60岁、皮下脂肪>3cm的患者均给予减张缝合。结果实验组切口甲级愈合率95%,乙级愈合率5%,丙级愈合率0%,没有一例切口敞开引流及切口裂开。对照组切口甲级愈合率65%,乙级愈合率23%,丙级愈合率12%,实验组甲级愈合率显著高于对照组。结论皮下置双腔管负压引流对预防外科腹部手术Ⅲ类切口感染及切口裂开的预防效果肯定,有效减少患者的痛苦,方法简便易行,适于推广。Objective To discuss the clinical value of the insertion of double - lumen tube with suction drainage under skin for abdominal incision of typeⅢ. Methods Divide 200 patients who have experienced abdominal operation with incision of typeⅢ into two equal parts at random. For group A, we suture peritoneum and muscles stitch by stitch, and sew up subcutis and skin as routine. For group B, we insert double - lumen tube before we close subcutis. For both groups who are older than 60 or whose subcutaneous fat 〉 3cm, we offer prophylactic tension suture. Results Group A： ratio of wound healing： A class 65%, B class 23%, C class 12%. Group B： ratio of wound healing： A class 95%, B class 5%, C class 0%. Wound dehiscence is not found. The ratio of A class healing in group B is significantly larger than that in group A. Conclusion Insertion of double - lumen tube with suction drairlage under skin is an effective method to reduce wound complications, prevent incision dehiscence after abdominal operation. The method which is easy and convenient worth to be publicized.

关 键 词：皮下置双腔管负压引流 腹部手术 Ⅲ类切口 

分 类 号：R656[医药卫生—外科学]