负压下不缝合脂肪层腹部切口缝合法 在结直肠肿瘤手术中应用.docVIP

负压下不缝合脂肪层腹部切口缝合法 在结直肠肿瘤手术中应用 　　[摘要] 目的 探讨负压下脂肪层不缝合的腹部切口缝合法在结直肠肿瘤手术中的应用。 方法 选择2010年1月～2012年12月辽宁省肿瘤医院手术治疗的结直肠肿瘤患者540例，按单双号分为A、B两组，每组各270例。A组为对照组，常规缝合切口，B组为实验组，皮下脂肪层不缝合。B组根据是否采用负压分为B1组80例和B2组190例，B1组采用非负压下脂肪层不缝合，B2组采用负压下脂肪层不缝合。观察并比较各组切口愈合情况及术后住院时间等。 结果 B1组和B2组患者切口感染率（2.50%、1.58%）、切口裂开率（2.50%、1.58%）及术后住院天数[（8.2±1.1）、（9.1±1.5）d]均明显低于A组[8.15%、6.67%、（12.0±3.8）d]，差异均有统计学意义（P 0.05）。B1组切口出血率（21.25%）及切口渗液率（16.25%）明显高于A组（4.44%、4.44%）和B2组（1.05%、1.05%），差异有统计学意义（P 0.05）；B2组切口出血率及切口渗液率（1.05%、1.05%）明显低于A组（4.44%、4.44%）和B1组（21.25%、16.25%），差异均有统计学意义（P 0.05）。 结论 皮下脂肪层不缝合可以减少切口感染、切口裂开的风险，缩短术后住院时间，但增加切口积液和出血的风险，不过此问题在采取给脂肪层造成负压状态缝合皮肤后就大大降低。 　　[关键词] 切口缝合；脂肪液化；切口感染 　　[中图分类号] R619.9[文献标识码] C[文章编号] 1673-7210（2014）06（c）-0140-03 　　 　　Application of the method of suture of incision without suturing fat layer under the negative pressure in the surgery of colorectal cancer 　　LIN Tao SONG Chun CHUO Dongyu ZHANG Hao ZHAO Jian 　　Department of Colorectal Surgery, Liaoning Cancer Hospital Institute, Liaoning Province, Shenyang 110042, China 　　[Abstract] Objective To investigate the application of suture of method of incision without suturing fat layer under negative pressure in colorectal cancer surgery. Methods A total of 540 patients of colorectal carcinoma from January 2010 to December 2012 in Liaoning Cancer Hospital Institute were selected divided into two groups according to treatment order with 270 cases in each group. Group A was the control group, and the patients in the control group were treated with conventional suture incision, group B was the experiment group, and the patients in the experiment group were performed with subcutaneous fat layer suture. The group B was divided into group B1 with 80 cases and group B2 with 190 cases. Group B1 was sewed up the incision without negative pressure and fat layer suture; group B2 was sewed up the incision with suturing fat layer under negative pressure. The incision healings and the hospitalization days were observed and compared bet