改良两针法连续缝合在回肠单腔造口术中的应用  

Application of modified two-stitch continuous suture method in single-lumen ileostomy

作　　者：蓝青楠 俞金龙[1] 余捷 何首华 翁起宁 罗桂芝[1] 邹琦 邹兆伟[1] Lan Qingnan;Yu Jinlong;Yu Jie;He Shouhua;Weng Qining;Luo Guizhi;Zou Qi;Zou Zhaowei(Department of General Surgery,Zhujiang Hospital of Southern Medical University,Guangzhou 510220,China)

机构地区：[1]南方医科大学珠江医院普通外科,广州510220

出　　处：《中华普通外科学文献（电子版）》2023年第4期278-281,共4页Chinese Archives of General Surgery(Electronic Edition)

摘　　要：目的探讨使用倒刺线的改良两针法连续缝合方式在回肠单腔造口术中的应用价值。方法回顾性分析2021年1月至2022年8月南方医科大学珠江医院行单腔回肠造口术92例患者的临床资料。根据造口方式不同分为改良两针法连续缝合造口组(改良两针法组32例)和传统造口组(60例),改良两针法连续缝合造口术使用免打结倒刺线连续缝合回肠造口。比较两组患者造口手术时间及术后造口相关并发症发生率。结果改良两针法组手术时间较传统造口组短[(14.3±1.1)min vs(25.1±2.4)min,t=24.332,P<0.001]。改良两针法组中造口皮肤黏膜分离、造口周围皮炎的发生率较传统造口组低(6.3%vs 31.7%,χ2=7.653,P=0.006;3.1%vs 28.3%,χ2=8.427,P=0.004),差异有统计学意义。两组间造口旁疝、造口脱垂、造口回缩的发生率及术后VAS评分差异无统计学意义。结论使用倒刺线的改良两针法连续缝合回肠造口术与传统造口术相比能显著缩短手术时间,具有操作简便、造口美观及减少造口相关术后并发症的优势。Objective To explore the application value of modified two-stitch continuous suture method in single-lumen ileostomy.Methods A total of 92 patients who underwent single-lumen ileostomy were retrospectively collected between January 2021 to August 2022 in Zhujiang Hospital of Southern Medical University.According to the different ileostomy methods,they were divided into modified two-stitch continuous suture ileostomy group(modified two-stitch group,32 cases)and traditional ileostomy group(60 cases).For modified two-stitch continuous suture ileostomy,the ileostomy was made by continuous suture method with barbed suture.The differences of postoperative ostomy-related complications and operation time were compared between the two groups.Results There were no significant differences in baseline data between the two groups.The operation time of modified two-stitch group was shorter than that of traditional ileostomy group[(14.3±1.1)min vs(25.1±2.4)min,t=24.332,P<0.001].The incidence of mucocutaneous separation and dermatitis in the modified two-stitch group were lower than those of the traditional ileostomy group(6.3%vs 31.7%,χ2=7.653,P=0.006;3.1%vs 28.3%,χ2=8.427,P=0.004).While the incidences of parastomal hernia,stoma prolapse,stoma rebound and postoperative VAS scores in the two groups were similar.Conclusion Compared with traditional ileostomy,the modified two-stitch continuous suture ileostomy can significantly shorten the operation time,and has the advantages of simple operation,beautiful stoma and reduced postoperative complications related to the ostomy.

关 键 词：倒刺线 回肠造口术 连续缝合 两针法 缝合技术 

分 类 号：R656.9[医药卫生—外科学]