妇产科下腹部横切口分层撕开法及皮下脂肪不缝合切口愈合临床观察.docVIP

妇产科下腹部横切口分层撕开法及皮下脂肪不缝合切口愈合临床观察 　　doi：10.3969/j.issn.1007-614x.2014.11.44 　　摘 要 目的：观察妇产科下腹部横切口分层撕开法开腹及皮下脂肪不?p合切口愈合情况，以改进妇产科下腹部横切口手术方法及缝合技术，减少下腹部横切口愈合不良，甚至感染。方法：收治妇产科下腹部横切口手术患者1560例，随机分为两组，观察组900例采用分层撕开法开腹及皮下脂肪不?p合，直接用4-0的可吸收线皮内连续缝合，对照组660例采用常规分层开腹，先缝合皮下脂肪，再用4-0的可吸收线皮内连续缝合。结果：两组不受年龄、切口处脂肪厚度、切口长度和下腹部横切口陈旧瘢痕的影响，观察组下腹部横切口手术时间、出血量、甲级愈合率、切口愈合时间、脂肪液化、切口感染、皮下硬结、术后发热症状构成比、平均住院时间、平均资源消耗、群众满意度调查结果均较对照组明显优化。切口部分裂开的50例中采用二期缝合、蝶型胶布牵拉对合，其愈合率达100%。结论：妇产科下腹部横切口分层撕开法开腹及皮下脂肪不缝合，脂肪液化少，甲级愈合率高，硬结少，愈合后呈线状，手术时间短，节约资源，住院时间短，平均住院费用低，群众满意高，医疗纠纷少，简单，易学，安全，深受广大医生的青睐。 　　关键词 妇产科 下腹部横切口 皮下脂肪 皮内缝合 切口甲级愈合 分层撕开 　　Clinical observation of wound healing of lower abdominal transverse incision hierarchical tearing method and subcutaneous fat without suture in obstetrics and gynecology department 　　Wen Aizhen 　　Gynaecology，the Peoples Hospital of Lingchuan County of Guilin City，Guangxi 541299 　　Abstract Objective：To observe the wound healing of lower abdominal transverse incision hierarchical tearing method and subcutaneous fat without suture in obstetrics and gynecology department in order to improve the lower abdominal transverse incision operation method and technique of suture in obstetrics and gynecology department，reduce poor healing of lower abdominal transverse incision and even infection.Methods：1560 operation patients with lower abdominal transverse incision were selected，they were randomly divided into two groups.900 cases of the observation group were treated by hierarchical tearing method and subcutaneous fat without suture，using intracutaneous continuous suture with 4-0 absorbable line.660 cases in the control group were treated with conventional layered open.First of all，the subcutaneous fat was sutured，then we took the intracutaneous continuous suture with 4-0 absorbable suture.Results：Effects of two groups were not affected by age，incision fat thickness，length of incision，and old scars of lower abdominal transverse incision.In the observation group，lower abdominal transverse incisio