改良腹壁整形技术在产后腹直肌分离症中的临床应用  

Clinical Application of Modified Abdominal Wall Plastic Surgery Technique in Postpartum Rectus Separation

作　　者：刘依帆 郑紫迎 赖廷廷 陈鹏飞 朱奕涵 黄和平 LIU Yifan;ZHENG Ziying;LAI Tingting;CHEN Pengfei;ZHU Yihan;HUANG Heping(Department of Medical Beauty,Affiliated Maternal and Child Health Hospital of Nanchang University,Nanchang 330000,Jiangxi,China)

机构地区：[1]南昌大学附属妇幼保健院医学美容科,江西南昌330000

出　　处：《中国美容医学》2022年第3期66-68,共3页Chinese Journal of Aesthetic Medicine

摘　　要：目的:讨论在产后腹直肌分离症的治疗中使用改良腹壁整形技术的临床效果。方法:将2017年4月-2020年11月笔者科室收治的17例产后腹直肌分离症患者作为研究对象,于腹壁肌后、腹膜前间隙置入相对较窄补片,将腹直肌及前直肌筋膜以8字形间断缝拢接近中线,以实现直接支撑性修复;切除腹壁多余的皮肤及皮下组织并分层缝合,最低点放置引流条引流渗液,术区妥善加压包扎。评估患者手术完成情况,手术时间,术后第1天疼痛视觉模拟评分,术后引流管拔除时间,痊愈情况。结果:2017年4月-2020年11月应用该方法共计17例,手术均顺利完成。无肠梗阻、补片感染、皮缘坏死、延迟愈合、补片感染及慢性疼痛等并发症,随访期间未有复发病例。结论:本研究提出的改良腹壁整形技术在产后腹直肌分离症的治疗中能获得更加持久可靠的疗效同时很大程度减少并发症的出现,具有良好的临床效果。Objective The study discusses the application and clinical effect of a modified abdominal wall plastic surgery technique in postpartum rectus separation.Methods 17 patients with postpartum rectus abdominis separation treated in our department from April 2017 to November 2020 were taken as the research object.A relatively narrow mesh was placed behind the abdominal wall muscle and in the anterior peritoneal space.The mesh was fixed by suture near the midline,and the rectus abdominis muscle and the anterior rectus fascia were sutured to the midline in an intermittent figure of 8 to achieve direct supportive repair.Excess skin and subcutaneous tissue of abdominal wall were removed and stratified suture was performed.Drainage strips were placed at the lowest point to drain the exudate,and the surgical area was properly pressurized and bandaged.Results From April 2017 to November 2020,a total of 17 cases were applied with this method.All the operations were completed successfully,including 1 case with incision fat liquefaction,which was cured after non-surgical treatment.There were no complications such as ileus,mesh infection,skin edge necrosis,delayed healing,mesh infection and chronic pain.There were no recurrent cases during the follow-up period.Conclusion This modified abdominal wall plastic surgery can achieve a more lasting and reliable effect in the treatment of postpartum rectus separation and greatly reduce the occurrence of complications,with good clinical results.

关 键 词：产后康复 腹直肌分离症 腹壁整形术 白线 腹直肌鞘 

分 类 号：R713[医药卫生—妇产科学]