高压氧联合中药加压外敷对肥胖孕妇剖宫产切口脂肪液化的影响

Effects of hyperbaric oxygen combined with external application of Chinese herbal medicine on fat liquefaction in cesarean section incision of obese pregnant women

目的探讨高压氧(hyperbaric oxygen,HBO)联合中药加压外敷对肥胖孕妇剖宫产切口脂肪液化的影响及其临床效果。方法选取2015年1月至2018年1月烟台山医院产科经剖宫产分娩后出现切口脂肪液化的肥胖孕妇360例,按照治疗方法分为2组,每组180例。对照组患者在术后常规治疗的基础上加用大黄、芒硝中药加压外敷手术切口;观察组患者在对照组的基础上加用HBO治疗。观察2组患者术后切口停止渗出时间及愈合情况、术后不同时间切口NRS疼痛评分、住院时间及患者满意度。结果观察组切口停止渗出时间、切口愈合等级及切口平均愈合时间明显优于对照组,差异有统计学意义(P<0.05);观察组患者3、4、5、7 d切口NRS疼痛评分明显低于对照组,差异有统计学意义(P<0.01);观察组患者住院时间6~11 d,平均(7.26±1.29)d,对照组患者住院时间9~23 d,平均(14.11±3.29)d,2组比较差异有统计学意义(P<0.01)。观察组患者满意度为95.56%(172/180),对照组为82.78%(149/180),2组比较差异有统计学意义(P<0.05)。结论HBO联合中药加压外敷对肥胖孕妇剖宫产切口脂肪液化有明显疗效,减轻患者的术后疼痛,降低患者住院时间,值得临床推广应用。

Objective To investigate the effects of hyperbaric oxygen (HBO) combined with Chinese herbal medicine on fat liquefaction in cesarean section incision of obese pregnant women and its clinical efficacy. Methods A retrospective analysis was made on 360 obese pregnant women with incision fat liquefaction after cesarean section in Yantaishan Hospital from January 2015 to January 2018. In accordance with different treatment methods, the patients were divided into 2 groups, each consisting of 180 patients. The patients in the control group were treated with rhubarb mirabilite and Chinese herbal medicine on the basis of routine treatment after surgery, while the patients in the observation group received HBO therapy in addition to therapy given to the control group. The length of exudation and wound healing after surgery, the NRS pain scores at different time points after surgery, hospitalization time and rate of patient satisfaction were closely observed in the patients of the 2 groups. Results The length of exudation, the rate of incision healing and the average time of incision healing in the observation group were significantly superior to those in the control group, and statistical significance could be seen when comparisons were made between the 2 groups (P<0.05). On the 3rd, 4th, 5th and 7th days after surgery, the NRS pain scores at the incision in the patients of the observation group were significantly lower than those in the patients of the control group, also with statistical significance (P<0.01). The patients of the observation group stayed in the hospital for 6 to 11 days, with an average length of stay for (7.26 ± 1.29) days, while the patients of the control group stayed in the hospital for 9 to 23 days, with an average length of stay for (14.11 ± 3.29) days. Statistical significance could be noted when comparisons were made between the 2 groups (P<0.01). The rate of satisfaction for the patients of the observation group was 95.56%(172/180), while that of the control group was 82.78%(149/180), with statistical significance (P<0.05). Conclusion HBO combined with external application of traditional Chinese herbal medicine could produce obvious effect on fat liquefaction of cesarean section incision in obese pregnant women, relieve pain after surgery and shorten the length of hospitalization. For this reason, it is worth further clinical extension.