间断缝合与连续缝合在体外循环胸部正中切口心脏瓣膜置换术中的应用研究  

Application of Interrupted Suture and Continuous Suture in Cardiac Valve Replacement with Extracorporeal Circulation Through Median Thoracic Incision

作　　者：水清[1] SHUI Qing(Department of Cardiac Macrovascular Surgery,Nanyang First People's Hospital,Nanyang Henan 473000,China)

机构地区：[1]南阳市第一人民医院心脏大血管外科,河南南阳473000

出　　处：《临床研究》2022年第8期12-15,共4页Clinical Research

摘　　要：目的探讨间断缝合与连续缝合在体外循环胸部正中切口心脏瓣膜置换术中的应用效果。方法选择2018年3月至2020年8月于南阳市第一人民医院行胸正中切口心脏瓣膜置换术的98例风湿性心脏病患者作为研究对象,以随机数字表法将其进行分组,其中对照组与研究组各纳入患者49例。两组心脏瓣膜置换术患者均行体外循环胸部正中切口心脏瓣膜置换术。其中对照组心脏瓣膜置换术患者采用间断缝合,研究组心脏瓣膜置换术患者采用连续缝合。观察并比较两组心脏瓣膜置换术患者切口愈合情况、主动脉阻断时间、心肺流转时间、呼吸机辅助时间、术后胸液引流量、手术缝合时间与住院时间,以及术后并发症情况。结果研究组切口的甲级愈合率高于对照组,差异有统计学意义(P<0.05)。研究组主动脉阻断时间、心肺流转时间、呼吸机辅助时间显著短于对照组,差异有统计学意义(P<0.01);术后胸液引流量低于对照组,差异有统计学意义(P<0.01)。研究组手术缝合时间、住院时间均短于对照组,差异有统计学意义(P<0.01)。研究组术后并发症发生率显著低于对照组,差异有统计学意义(P<0.05)。结论相较于间断缝合,连续缝合在体外循环胸部正中切口心脏瓣膜置换术中具有更为理想的应用效果,可以提高切口愈合质量,减少并发症风险,加快康复速度,适于临床应用。Objective To investigate the use of interrupted suture and continuous suture in cardiac valve replacement with extracorporeal circulation through median thoracic incision.Methods A total of 98 patients with rheumatic heart disease who underwent thoracic median incision heart valve replacement at the First People's Hospital of Nanyang City from March 2018 to August 2020 were selected as study subjects and grouped by random number table method,with 49 patients included in the control group and 49 patients in the study group.Two groups of heart valve replacement patients underwent extracorporeal circulation chest median incision heart valve replacement.Patients in the control group were treated with intermittent suture,and patients in the study group were treated with continuous suture.The incision healing,aortic clamping time,cardiopulmonary bypass time,ventilator assisted time,postoperative thoracic drainage,surgical suture time and hospitalization time,and postoperative complications were observed and compared between the two groups.Results The grade A healing rate of incision in the study group was higher than that in the control group,and the difference was statistically significant(P<0.05).The aortic occlusion time,cardiopulmonary circulation time and ventilator-assisted time in the study group were significantly shorter than those in the control group,and the differences were statistically significant(P<0.01).The postoperative pleural effusion drainage was lower than that in the control group,and the difference was statistically significant(P<0.01).The operation suture time and hospitalization time of the study group were shorter than those of the control group,with statistically significant differences(P<0.01).The incidence of postoperative complications in the study group was significantly lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion Compared with interrupted suture,continuous suture is more ideal for use in median thoracic incision heart valve rep

关 键 词：连续缝合 间断缝合 体外循环 胸部正中切口 心脏瓣膜置换术 

分 类 号：R542.5[医药卫生—心血管疾病]