两种生物可吸收缝合线在腹壁手术中的应用比较  

Comparison of two absorbable sutures in abdominal wall incision

作　　者：庄潮平[1] 蔡高阳[1] 王永全[1] 

机构地区：[1]汕头大学医学院第二附属医院,广东省汕头市515041

出　　处：《中国组织工程研究与临床康复》2009年第21期4045-4048,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：背景:近年来,随着生物材料学的发展,不同化学成分和生物学特性的缝线被广泛应用于临床,不同缝线的选择是临床医生必须考虑和权衡的问题。目的:对比观察抗菌可吸收线和聚对二氧环己酮可吸收线在腹部切口的应用效果。设计、时间及地点:对比观察,病例来自2005-01/2007-08汕头大学医学院第二附属医院普外科。对象:选择剖腹手术患者450例,男230例,女220例,年龄18～78岁,平均年龄(40±9)岁。方法:450例患者随机分为3组,抗菌可吸收缝线组:采用预涂有抗菌剂三氯生的可吸收缝线全层连续缝合腹壁切口(皮肤层除外);可吸收缝线组:采用可吸收缝线聚对二氧环己酮全层连续缝合腹壁切口(皮肤层除外);对照组:采用普通丝线分层间断缝合腹壁切口,每组患者150例。术后随访12～24个月。主要观察指标:3组患者术后疼痛评分(采用目测类比评分:0分为无痛,10分为剧痛)、切口愈合分级及术后并发症发生情况(切口感染、排异反应、瘢痕形成、切口裂开、切口疝)。结果:450例剖腹手术患者均进入结果分析。抗菌可吸收缝线组和可吸收缝线组术后疼痛评分明显低于对照组,差异有显著性意义(P<0.05);对照组150例患者中有6例切口乙级愈合,明显高其他两组(P<0.05);抗菌可吸收缝线组和可吸收缝线组术后并发症低于对照组(P<0.05),其中抗菌可吸收缝线组切口感染率最低(P<0.01)。结论:可吸收缝线缝合腹壁切口安全可靠,无排异反应;能减轻切口疼痛,减少异物残留和瘢痕形成,减少切口裂开和切口疝的发生率;抗菌可吸收缝线能明显降低切口感染率。BACKGROUND： In resent year, as the biological materials improving, all kinds of sutures are used widely in clinic. It is an important problem how to select the exact one for surgeon. OBJECTIVE： To compare the effect of antibacterial and poly （p-dioxanone） absorbable sutures （PDS） in abdominal wall incision. DESIGN, TIME AND SETTING： A contrast observation was performed at the Department of General Surgery, the Second Affiliated Hospital of Shantou University Medical College between January 2005 and August 2007. PARTICIPANTS： A total of 450 laparotomy patients, including 230 males and 220 females aging 18-78 years with the mean age of （40＋9） years were collected in this study. METHODS： The 450 patients were randomly divided into three groups, including the antibacterial absorbable suture （AAS; abdominal wall incision except the skin was successively sutured with triclosan-coated antibacterial absorbable suture）, PDS group （abdominal wall incision except the skin was successively sutured with PDS suture）, and control group （abdominal wall incision was treated with common suture）, with 150 cases in each group. All patients were followed up for 12 24 months. MAIN OUTCOME MEASURES： The visual analogue scale （VAS; point 0： indolence; point 10： severe pain）, the incision heal classification and complications including incisional infection, rejection reaction, scar formation, incisional disruption and incisional hernia. RESULTS： A total of 450 cases were included in the final analysis. The VAS in the AAS group and the PDS group were significantly lower than control group （P 〈 0.05）. Among 150 cases in the control group, 6 patients had the grade Ⅱ incision healing, which was significantly higher than other two suture groups （P 〈 0.05）.The complications in the AAS group and the PDS group were significantly lower than the control group （P 〈 0.05）; in particular, the incisional infection was the lowest in the AAS group （P 〈 0.01 ）. CONCLUSION： The us

关 键 词：抗菌可吸收缝线 PDS可吸收缝线 腹部切口 

分 类 号：R318[医药卫生—生物医学工程]