不缝合脂肪在妇科纵切口手术中的临床观察  

Clinical Observation on Suture without Suturing Fat in Gynecologic Longitudinal Incisions

作　　者：金钰铌[1] 张学军[2] 许静[1] 侯平[1] 

机构地区：[1]昆明医科大学第一附属医院,云南昆明650031 [2]成都军区昆明总医院,云南昆明650032

出　　处：《昆明医科大学学报》2012年第9期115-117,共3页Journal of Kunming Medical University

摘　　要：目的改进妇产科下腹部切口的缝合方法,提高切口Ⅰ期愈合率及减少并发症.方法将下腹部手术切口皮下脂肪层不缝合89例设为观察组,丝线皮下脂肪层间断缝合97例设为对照组,2组进行切口愈合情况的比较.结果术前2组患者基本情况一致.在术后患者出现发热症状的构成比上,观察组明显低于对照组,其差异有统计学意义(P<0.05).2组术后切口愈合级别以甲级愈合为主,其差异无统计学意义(P>0.05).从术后切口并发症角度看,2组均无切口感染、切口异物肉芽肿形成和窦道形成,此外,观察组出现切口液化的构成比明显少于对照组,其差异有统计学意义(P<0.01),但观察组切口有活动性淡血性渗出25例.结论不缝合脂肪在妇科纵切口手术中,不改变切口Ⅰ期愈合率,但能缩短缝合时间,减少了脂肪液化,切口愈合美观,减轻了术后腹部牵拉感。Objective To improve the suture of hypogastrium incision of obstetrics and gynecology so as to accelerate the incisional I stage healing rate and reduce complications.Methods 89 patients who underwent the intradermicsuture of hypogastrium surgical incision and the fatty layer below the skin without suturing were selected into the observation group.97 patients who underwent skin intradermal suture method after interrupted suture of silk thread subcutaneous fat layer were grouped into the control group.The situations of wound healing of patients were compared between the two groups.Results The situations of patients in the two groups were same before the operation.But in terms of the constituent ratio of postoperation fever symptom,observation group was significantly lower than control group,and the differences were of statistical significance（P0.05）.Postoperation wound healing of the two groups was almost first-stage,and the differences were not of statistical significance（P0.05）.For the postoperative incision complications,it showed no surgical site infection,no incision foreign body granuloma,and no sinus tract happening,except for incisional active bleeding found on three patients and incisional crack on two patients in control group,and no patients in observation group were found with such situations.There were 25 patients appearing active ooze blood in observation group.Besides,constituent ratio of incision liquefaction appearing in observation group was obviously less than that in control group,and the differences were of statistical significance（P0.01）.Conclusion The new approach of nonsuturing fat in the gynecological operation of longitudinal incision,features advantages on unchanging incisional I stage healing rate,shortening suturing time,limiting liquefaction of fat,beautifying the wound and reducing the feeling of belly＇s pulling,is worthy of application.

关 键 词：下腹部切口 不缝合脂肪 皮内缝合 

分 类 号：R713[医药卫生—妇产科学]