影响心脏术后早期前胸裂开切口愈合因素的临床分析  

Clinical analysis of factors influencing the healing of anterior thorax incision in early postoperative cardiac surgery

作　　者：侯玉森[1] 曹玉珏[1] 余斌[1] 马彩虹[1] 屠海霞[1] 赵鹏亮[1] 朱海涛[1] 郑介飞[1] Hou Yusen;Cao Yujue;Yu Bin;Ma Caihong;Tu Haixia;Zhao Pengliang;Zhu Haitao;Zheng Jiefei(Department of Burns and Plastic Surgery, Beijing Fengtai You Anmen Hospital, Beijing 100069, China)

机构地区：[1]北京丰台右安门医院烧伤整形科,100069

出　　处：《中华损伤与修复杂志（电子版）》2020年第3期210-214,共5页Chinese Journal of Injury Repair and Wound Healing(Electronic Edition)

摘　　要：目的探讨年龄、糖尿病、感染、负压封闭引流技术治疗因素对心脏术后早期前胸裂开切口愈合的影响。方法选择2017年7月至2019年7月北京丰台右安门医院烧伤整形科收治的261例心脏术后早期前胸切口裂开不愈患者。依据年龄、合并糖尿病与否、感染与否、是否采用负压封闭引流技术治疗4个因素,将患者分别分为2组。低龄组(≤56岁)109例,高龄组(>56岁)152例;糖尿病组111例,非糖尿病组150例;感染组146例,非感染组115例;负压封闭引流组119例,非负压封闭引流组142例。通过网络或门诊随访患者胸骨切口皮肤有无红肿及破溃。评价比较各2组患者术后切口愈合时间及住院时间。数据比较采用t检验。结果随访3~6个月患者胸骨切口皮肤均无红肿及破溃。低龄组患者切口愈合时间、住院时间分别为(12.7±3.6)、(24.9±9.5)d,与高龄组[(17.8±5.4)、(30.7±14.2)d]比较,差异均有统计学意义(t=9.359、13.861,P值均小于0.05)。糖尿病组患者切口愈合时间、住院时间分别为(15.4±4.6)、(29.1±12.4)d,与非糖尿病组[(14.7±3.8)、(27.7±9.1)d]比较,差异均无统计学意义(t=0.162、0.031,P值均大于0.05)。感染组患者切口愈合时间、住院时间分别为(15.5±4.3)、(30.6±14.1)d,与非感染组[(14.3±4.2)、(29.6±12.7)d]比较,差异均无统计学意义(t=0.775、0.648,P值均大于0.05)。负压封闭引流组切口愈合时间、住院时间分别为(11.6±3.7)、(32.4±13.2)d,与非负压封闭引流组[(15.7±4.2)、(23.9±10.7)d]比较,差异均有统计学意义(t=6.831、3.957,P值均小于0.05)。结论糖尿病、感染等因素并不影响心脏术后早期前胸裂开切口的愈合时间,负压封闭引流治疗可缩短术后切口愈合时间,年龄可作为判断切口愈合时间长短的一个重要指标。Objective To investigate the influence of age,diabetes,infection and negative pressure treatment on the healing of anterior thorax incision in early postoperative cardiac surgery.Methods Two hundred and sixty one patients with early postoperative dehiscence of anterior thorax incision were selected from July 2017 to July 2019 in the Department of Burns and Plastic Surgery,Beijing Fengtai You Anmen Hospital.Patients were divided into 2 groups respectively according to different factors of age,diabetes or not,infection or not,whether to use negative pressure closure drainage treatment.There were 109 cases in the younger group(≤56 years old)and 152 cases in the older group(>56 years old).There were 111 cases in the diabetic group and 150 cases in the non-diabetic group.There were 146 cases in the infected group and 115 cases in the non-infected group.There were 119 cases in the negative pressure closure drainage group and 142 cases in the non-negative pressure closure drainage group.The patients were followed up online or in the outpatient for redness,swelling and rupture of the sternal incision skin.Incision healing time and hospital stay of two groups of patients were evaluated and compared.The data were processed with t test.Results No redness,swelling or ulceration of the sternal incision skin was observed in the patients after 3-6 months of follow-up.The incision healing time and the length of hospital stay in the younger group were(12.7±3.6),(24.9±9.5)d respectively,compared with the older group[(17.8±5.4),(30.7±14.2)d],the differences were statistically significant(t=9.359,13.861;with P values below 0.05).The incision healing time and the length of hospital stay in the diabetic group were(15.4±4.6),(29.1±12.4)d respectively,compared with the non-diabetic group[(14.7±3.8),(27.7±9.1)d],the differences were not statistically significant(t=0.162,0.031;with P values above 0.05).The incision healing time and the length of hospital stay in infected group were(15.5±4.3),(30.6±14.1)d respectively,compared

关 键 词：外科伤口裂开 伤口愈合 负压伤口疗法 年龄因素 糖尿病 感染 心脏手术 

分 类 号：R47[医药卫生—护理学]