改良“瞄准器”状缝合术在回肠预防性造口还纳术中的应用  

Application effects of modified gunsight technique closure of the wound following protective ileostomy reversal

作　　者：张垒 胡静 晁娟 肖志强 苗同林 单长岭 ZHANG Lei;HU Jing;CHAO Juan;XIAO Zhi-qiang;MIAO Tong-lin;SHAN Chang-ling(Department General Surgery,the Affiliated Jinxiang′s Hospital of Jining Medical College,Jining,Shandong 272200,China)

机构地区：[1]山东省济宁医学院附属金乡医院胃肠外科,山东济宁272200

出　　处：《岭南现代临床外科》2022年第4期336-339,353,共5页Lingnan Modern Clinics in Surgery

摘　　要：目的探讨改良“瞄准器”状缝合术处理回肠造口还纳术后腹壁切口的应用效果。方法回顾性分析2019年2月至2022年2月间笔者团队收治的58例回肠造口还纳术患者病例资料,根据造口还纳术后腹壁切口缝合方式的不同,将研究对象分为观察组(26例)及对照组(32例),观察组采用改良“瞄准器”状缝合术,对照组采用传统一期缝合术。比较两组患者的手术时间、术中出血量、术后进食时间、拆线时间、术后住院时间、切口感染率及术后切口疼痛评分。结果观察组术后进食时间、拆线时间、术后住院时间、术后第一天疼痛评分及切口感染率明显低于对照组(均P<0.05)。两组手术时间、术中出血量差异比较未见统计学意义(均P>0.05)。结论与传统一期缝合术相比,改良“瞄准器”状缝合术处理腹壁切口可明显降低回肠造口术后切口感染率及术后第一天疼痛感,缩短术后进食时间、拆线时间及术后住院时间。Objective To explore the application effects of modified gunsight skin incision and suture technique in the treatment of ileostomy closure after abdominal wall incision.Methods Fifty-eight patients of ileostomy from February 2019 to February 2022 in our hospital were also retrospectively analyzed,the subjects were divided into observation group(n=26)and control group(n=32).The patients in the observation group were treated with modified gunsight technique while the control group with traditional primary suture.The operative time,intraoperative blood loss,postoperative diet time,stitches removing time,postoperative hospital stay,wound infection rate and postoperative pain score were compared between the two groups.Results The postoperative diet time,stitches removing time,postoperative hospital stay,wound infection rate and pain score on the first postoperative day of the observation group were significantly lower than those of the control group(all P values<0.05).There were no significant difference in the operative time and intraoperative blood loss between the two groups(all P values>0.05).Conclusion Compared with the traditional primary suture,the modified gunsight technique can effectively reduce postoperative diet time,stitches removing time,postoperative hospital stay,wound infection and pain on the first postoperative day.

关 键 词：改良瞄准器状缝合术 回肠造口 回肠还纳 

分 类 号：R608[医药卫生—外科学] R656.7[医药卫生—临床医学]