不缝合腹膜预防阑尾切口感染355例分析  

Aralysis of 355 patients with non-suturing peritoneum in preventing purulent infection of incisional wound of appendicitis

作　　者：赵沨[1] 

机构地区：[1]淮南市第一人民医院普外科,安徽省淮南232007

出　　处：《中国基层医药》2010年第23期3225-3226,共2页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的 探讨降低化脓性、穿孔性、坏疽性阑尾炎手术切口感染的方法. 方法 将907例化脓性、穿孔性、坏疽性阑尾炎907例患者随机分成不缝合腹膜组（不缝组）355例和对照组552例,不缝合腹膜组关闭腹腔时开放腹膜不缝合,对照组关闭腹腔时关腹时常规缝合腹膜.观察切口肿痛、发红、压痛,是否有脓性分泌物、体温异常平均天数、切口愈合等级及平均住院天数. 结果 不缝合腹膜组：切口感染21例（5.9%）、体温异常（3.8±1）d、住院（7.5±1）d;对照组：切口感染119例（21.6%）、体温异常平均（4.3±1）d、平均住院（12.9±1）d.不缝组切口甲级愈合率亦明显优于对照组（P＜0.05）. 结论 不缝合腹膜可起到内引流作用,是预防切口感染的有效方法,对缩短平均体温异常天数及平均住院天数有较大意义.同时也并不会增加肠粘连,切口疝的发生概率.Objective To explore the effect of mon-suturing peritoneum in perforating purulent infection of incisional wound of appendicitis. Methods 907 patients suffered purulent perforating and gangrenous appendicitis were divided randomly into two groups：the non-suturing group of 355 patients and the control group of 552 patients.Of the non-suturing group,peritoneum was not sutured when his/her abdominal cavity was closed.It was just on the contrary to the control group.Then examined whether eoncotic rythrogenic or tender incision occurred,or whether purulent secretion flowed outside from the operative incision.These items below were also been recorded carefully：the average number of days when the temperature was abnormal,the grades of healing of incision and the average hospital stay. Results In the non-suturing group,21（5.9%）patients suffered postoperative infection,the number of days of abnormal temperature was（3.8 ± 1）d on average,and the average hospital stay was（7.5 ± 1）d;in the control group,119（21.6%）patients suffered postoperative infection,the number of days of abnormal temperature was（4.3 ± 1）d on average,and the average hospital stay was（12.9 ± 1）d.First rate healing of incision in the non-suturing group was far higher than that in the control group（P〈0.05）. Conclusion Non-suturing peritoneum could help internal drainage peritoneum,which was an efficient way to guard against the postoperative infection.And non-suturing was also of great significance to reduce the average number of days of abnormal temperature and hospital stay.Meanwhile,the probability of ankylenteron and incisional hernia was not increased.

关 键 词：阑尾炎 剖腹术 腹膜 

分 类 号：R656[医药卫生—外科学]