弹性钩线针缝合腹腔镜手术小切口的临床价值研究  

Study on the clinical value of sewing up incision by elastic snell needle in laparoscopic operation

作　　者：方向[1] 麦刚[1] 刘忠亮[1] 张跃天[1] 郑本波[1] 刘震[1] 

机构地区：[1]四川省德阳市人民医院普外科,四川德阳618000

出　　处：《中国普外基础与临床杂志》2017年第1期59-63,共5页Chinese Journal of Bases and Clinics In General Surgery

基　　金：四川省医学科研课题(项目编号:S15030)

摘　　要：目的研究一种能够预防腹腔镜术后切口并发症的简单、实用及价廉的缝合方法。方法使用弹性钩线针在腹腔镜直视下缝合小切口,将用弹性钩线针进行分层缝合切口的腹腔镜手术患者3 120例设为研究组,将用传统弧形针缝合的腹腔镜手术患者3 120例设为对照组,比较2组患者术后切口疝和切口出血的发生率。结果研究组术后切口出血发生率为0.16%,其中上腹部手术为0.15%,下腹部手术为0.18%;对照组术后切口出血发生率为0.68%,其中上腹部手术为0.64%,下腹部手术为0.70%;研究组与对照组比较,术后切口出血的发生率显著降低(P<0.05),下腹部手术术后切口出血的发生率也显著降低(P<0.05)。研究组术后切口疝发生率为0.07%,其中上腹部手术为0,下腹部手术为0.12%,老年人手术为0.15%;对照组术后切口疝发生率为0.44%,其中上腹部手术为0.24%,下腹部手术为0.59%,老年人手术为0.99%;研究组与对照组比较,术后切口疝的发生率显著降低(P<0.05),下腹部手术术后切口疝的发生率也显著降低(P<0.05)。结论使用弹性钩线针在腹腔镜直视下缝合小切口,能够在不延长切口和不增加医疗费用的情况下将腹膜层和肌层对位缝合,能够发现并缝合结扎切口处合并存在的隐匿疝和腹壁缺损,从而能够显著降低腹腔镜术后切口疝和切口出血的发生率。Objective To find a simple, practical and cheap way in suturation to prevent incision complications after celoscope surgery. Methods Using the elastic snell needle to stitch small incision under laparoscopy. Chosed 3 120 cases using the elastic snell needle to stitch stratified suturation as research group, and 3 120 cases by using trditional arc shaped needle in celoscope surgery as control group. The incident rate of incisional hernia and incision bleeding among groups were compared. Results In research group, the incident rate of incision bleeding was 0.16%, among which was 0.15% in epigastrium group, 0.18% in hypogastrium group, while in control group, the incident rate of incision bleeding was 0.68%, among which was 0.64% in epigastrium group, 0.70% in hypogastrium group. The incident rate of incision bleeding was obviously decreased （P〈0.05）, and the incident rate of incision bleeding in hypogastrium group was obviously decreased as well （P〈0.05）, compared research group and control group. In research group, the incident rate of incisional hernia was 0.07%, among which was 0 in epigastrium group, 0.12% in hypogastrium group, 0.15% in gerontism group, while in control group, the incident rate of incisional hernia was 0.44%, among which was 0.24% in epigastrium group, 0.59% in hypogastrium group, 0.99% in gerontism group, and the incident rate of incisional hernia after surgery was obviously decreased （P〈0.05）, the incident rate of incisional hernia after surgery in hypogastrium group was obviously decreased as well （P〈0.05）, comparing research group and control group. Conclusions Using the elastic snell needle to stitch small incision under laparoscopy, the peritoneal layer and muscular layer can be apposition sutured in the case without prolonging incision and costing more, hidden hernia and abdominal wall defects located at the incision can be found, ligation and stitched, thereby the incident rate of incisional hernia and incisional bleeding after celoscope surgery are significantl

关 键 词：腹腔镜 弹性钩线针 切口疝 切口出血 缝合方法 

分 类 号：R616[医药卫生—外科学]