腹腔镜胆囊切除术三种切口缝合方法的临床疗效观察  

The clinical efficacy of three methods for closing incisions in laparoscopic cholecystectomy

作　　者：王立宇[1] 孟镔[1] 叶松[1] 张丽康[1] 孟迪生[1] 胡军 范元军 李伟 

机构地区：[1]安徽理工大学医学院临床外科应用解剖教研室 [2]富阳市中医院 [3]芜湖市第一人民医院 [4]解放军73658部队医院

出　　处：《腹腔镜外科杂志》2014年第8期603-606,共4页Journal of Laparoscopic Surgery

摘　　要：目的:探讨腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)中三种切口闭合方法的应用价值,总结LC术后戳孔疝的预防措施。方法:回顾分析2008年1月至2013年10月为421例患者行LC的临床资料,术中分别采用皮肤全层缝合法、皮肤皮下缝合法、腹壁全层缝合法闭合切口。结果:皮肤全层缝合法术后7例(7.1%)发生戳孔疝,皮肤皮下缝合法术后发生4例(1.5%),腹壁全层缝合法无一例发生切口疝。结论:LC术后戳孔疝的发生多见于皮肤全层缝合法,皮肤皮下缝合法次之,腹壁全层缝合法可预防戳孔疝的发生。封闭腹壁各层切口缺损是避免戳孔疝发生的关键。Objective：To investigate the value of three methods for closing incisions in laparoscopic cholecystectomy （LC）, and to summarize the prevention measures for incisional hernia after LC. Methods ：The clinical data of 421 patients who underwent LC from Jan. 2008 to Oct. 2013 were retrospectively analyzed. Whole skin suture, the skin-subcutaneous suture and full abdominal wall layer suture were used to close the incisions respectively. Results：Ineisional hernia occurred after using whole skin suture and the skin-sub- cutaneous suture,which were 7 cases （7.1%） and a, cases （ 1.5% ） respectively. While full abdominal wall layer suture didn＇ t result in the hernia. Conclusions：The hernias after LC are most commonly observed in whole skin suture, followed by the skin-subcutaneous suture. And full abdominal wall layer suture could prevent the occurrence of hernia. The key to prevent incisional hernia is to close the defect of the incision in all abdominal wall layers.

关 键 词：胆囊切除术 腹腔镜 切口疝 皮肤全层缝合法 皮肤皮下缝合法 腹壁全层缝合法 

分 类 号：R657.4[医药卫生—外科学]