三种不同缝合线对腹壁手术切口愈合质量影响的研究  

Study on The Effect of Three Kinds of Different Suture on The Healing Quality of Abdominal Incision

作　　者：李利发 张井潇 陈小波[1] 周瑜[4] 张广军[1] 周何[2] 李雨[1] 周彤[1,2] 

机构地区：[1]川北医学院附属医院胃肠外科,四川南充637000 [2]川北医学院肝胆胰肠研究所,四川南充637000 [3]川北医学院附属医院心内科,四川南充637000 [4]川北医学院附属医院胸心外科,四川南充637000

出　　处：《中国普外基础与临床杂志》2016年第4期445-449,共5页Chinese Journal of Bases and Clinics In General Surgery

摘　　要：目的探讨不同手术缝合线对腹部手术切口愈合质量的影响,为促进腹壁手术切口的愈合提供新的理论依据。方法将2013年6月至2015年6月川北医学院附属医院普通外科收治的341例行开腹手术患者按时间表随机分组方法随机分为3组,即聚对二氧环己酮Ⅱ缝合线(polydioxanonⅡsuture,PDSⅡ缝合线)组,采用PDSⅡ缝合线全筋膜层连续缝合腹壁切口;薇乔线组,采用抗菌薇乔线全筋膜层连续缝合腹壁切口;普通丝线组,采用普通丝线分层间断缝合腹壁切口。比较3组患者切口愈合质量。结果对于缝合时间而言,PDSⅡ缝合线组为(11.23±1.62)min,短于薇乔线组的(14.04±1.20)min,其差异具有统计学意义(P<0.05),且上述2组的缝合时间均短于普通丝线组的(21.95±1.95)min,差异具有统计学意义(P<0.05)。在排异反应、切口感染和切口裂开发生率方面,PDSⅡ缝合线组和薇乔线组均较普通丝线组低,差异均具有统计学意义(P<0.05),而PDSⅡ缝合线组与薇乔线组相比,差异则不具有统计学意义(P>0.05)。在术后住院时间和切口脂肪液化、积液方面,3组间相比差异均无统计学意义(P>0.05)。结论 PDSⅡ缝合线和抗菌薇乔线全筋膜层连续缝合腹壁切口可明显缩短缝合时间,降低术后切口排异反应、切口感染和切口裂开的发生率,有助于患者术后快速康复。Objective To research the effect of different surgical sutures on abdominal surgical incision healing quality, and provide a novel theory basis for promoting the healing of incision of abdominal wall. Methods Totally 341 patients who underwent laparotomy were collected from general surgery of Affiliated Hospital of North Sichuan Medical College, and they were randomly divided into three groups： the including polydioxanone Ⅱ（PDS Ⅱ） suture group, abdominal wall incision except the skin was successively sutured with PDS Ⅱ suture; the Vicryl group, abdominal wall incision except the skin was successively suture with antibacterial Vicryl; and the common silk thread group, abdominal wall incision was performed layering intermittent silk suture. Results In terms of suture time, the PDS Ⅱ suture group 〔（11.23±1.62） min〕 was significantly lower than the Vicryl group 〔（14.04±1.20） min〕, P〈0.05, and also both were significantly lower than the ordinary silk thread group 〔（21.95±1.95） min〕, P〈0.05. In respect of rejection reaction, incision infection and incision split, the PDS Ⅱ suture group and the Vicryl group were significantly lower than the ordinary silk thread group（P〈0.05）, but compared the PDS Ⅱ suture group with the Vicryl group, the differences were not statistically significant（P〉0.05）. Regarding post operation hospitalization duration, fat liquefaction and effusion, compared the differences between the three groups were not statistically significant（P〉0.05）. Conclusion Full fascia is successively suture with PDS Ⅱ sutures and antibacterial Vicryl suture that can significantly shorten the suture time, reduce the incidence of rejection incision, wound infection and wound dehiscence and promote the postoperative recovery of the patients.

关 键 词：PDSⅡ缝合线 薇乔线 腹部手术 腹壁切口 愈合质量 

分 类 号：R656[医药卫生—外科学]